Hi everyone,
Well, I am now in my tenth week of my first pregnancy and my CH started last week. I am getting up to three CH's a night. Which, in the first week of a cluster is totally uncharacteristic for me.  Maybe it is the hormones, who knows.  I have read as many research articles that I can from this site and others and from what I have read, oxygen is the preferred treatment during pregnancy.  I got oxygen tanks from my GP and for the first time in 17 years of CH's I actually have true relief from the O2. (every year i try, hoping that one year it will finally work). My question is this, has anyone on this site had a cluster during their first trimester and what did you do?  I dont want articles, I want to hear tried and true.  Also, has anyone heard that the O2 can be dangerous in any way??  I mean, we use it different than most people.  We basically OD on oxygen to get relief :)
Is there any safe (tried and true) PREVENTATIVE treatments?  Because, although the oxygen is helpful, I still have to get up 3 times in the night and sit on the oxygen for 10-20 min. 
I appreciate any feedback. Tomorrow I have an appointment with my neurologist/headache specialist and I want to go prepared. Thank you again!!
Jennifer

Sorry that I can't give you my personal experiences but hope this help:

Cephalalgia. 2009 Jan 19. 
Treatment of cluster headache in pregnancy and lactation.

Jüergens TP, Schaefer C, May A.
Department of Neurology, University of Regensburg, Regensburg, Germany.

Treatment of cluster headache in pregnancy and lactation. Cephalalgia 2009. London. ISSN 0333-1024

Cluster headache is a rare disorder in women, but has a serious impact on the affected woman's life, especially on family planning. Women with cluster headache who are pregnant need special support, including the expertise of an experienced headache centre, an experienced gynaecologist and possibly a teratology information centre. The patient should be seen through all stages of the pregnancy. A detailed briefing about the risks and safety of various treatment options is mandatory. In general, both the number of medications and the dosage should be kept as low as possible. PREFERRED TREATMENTS INCLUDE OXYGEN, SUBCUTANEOUS OR INTRANASAL SUMATRIPTAN FOR ACUTE PAIN AND VERAPAMIL AND PREDNISONE/PREDNISOLONE AS PREVENTATIVES. IF THERE IS A COMPELLING REASON TO TREAT THE PATIENT WITH ANOTHER PREVENTATIVE, GABAPENTIN IS THE DRUG OF CHOICE.

WHILE BREASTFEEDING, OXYGEN, SUMATRIPTAN AND LIDOCAINE FOR ACUTE PAIN AND PREDNISONE/PREDNISOLONE, VERAPAMIL, AND LITHIUM AS PREVENTATIVES ARE THE DRUGS OF CHOICE. As the individual pharmacokinetics differ substantially, adverse drug effects should be considered if unexplained symptoms occur in the newborn.

PMID: 19170693

Hey JM,

Oxygen therapy is the safest cluster headache abortive, even at flow rates that support hyperventilation.  There are no side effects.  You and your baby need oxygen to live...  You can't say that about imitrex or zomig as cluster headache abortives or verapamil as a cluster headache preventative...

During a typical oxygen therapy session where you breath oxygen to abort (stop) the cluster headache and pain completely, you will breathe 100% oxygen for 3 to 20 minutes depending on the pain level.

You would need to breathe 100% oxygen continuously for 12 to 18 hours without a break breathing room air to start feeling the effects of oxygen toxicity.

How much vitamin D3 are you taking as prescribed or suggested by your OB as part of your prenatal clutch of supplements?

A consensus of several vitamin D3 experts (endocrinologists, OB/GYN, pediatricians) regarding how much to take during pregnancy and breast feeding indicates a minimum of 6000 IU/day plus the vitamin D3 cofactors... is essential... Taking more up to 10,000 IU/day is likely better. 

Dr. E. Orbermer of Italy wrote the following:

    “Until further experimental evidence, adequate and incontrovertible, is made available, I submit that we should play for safety. In a climate like that of England every pregnant woman should be given a supplement of vitamin D in doses of not less than 10,000 IU per day in the first 7 months, and 20,000 IU (per day) during the 8th and 9th months.”

"For the past five years I have been recommending to all personally known pregnant women to take 10,000 IU of vitaminD3 and also supplement with high dose omega 3. one young lady send me an youtube of her baby laying on daddy’s chest on her abdomen and mother called baby’s name and literally she lifted her head and looked around to see where the voice came from and mother commented that she attributes this to her supplement intake. All the children of mothers who had taken adequate amount of D3 shows remarkable alertness, agility, observation, attention and are overall very calm and always in a playful mood. I have grand parents thanking me for my recommendation."
Ashok Patel MD

Don't take my word for it... Read through the following links and see for yourself.

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

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

The wonderful thing about vitamin D3 is you can have its status measured with a simple lab test for 25-Hydroxyvitamin D, a.k.a. 25(OH)D.  The normal reference range for this lab test is 32 to 100 ng/mL. 

That makes 68 ng/mL the mid point in the "normal" reference range and a good target serum concentration of 25(OH)D to shoot for.

So ask your OB for this lab test at the first opportunity or call him to ask for this test today.

If your results come back 20-32 ng/mL, your vitamin D3 intake is insufficient.  If your 25(OH)D serum concentration is less than 20 ng/mL, you're vitamin D3 deficient.  Neither case is good for your baby...

See your OB and get this lab test ASAP! then work with your OB to adjust your vitamin D3 intake to achieve the ideal/target 25(OH)D serum concentration.

If you follow the chart below, you'll see that a vitamin D3 intake of 10,000 IU/day results in a serum concentration of 85 ng/mL.  That's still well within the normal reference range...  It is also sufficient to help prevent your cluster headaches.

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

You'll also notice the "green zone" on this chart.  That represents the range of 25(OH)D serum concentrations where 80% of the CH'ers who take vitamin D3 experience a significant reduction in the frequency, severity and duration of their cluster headaches... or go pain free...

Show this chart to your OB as well.

So there you have it...  Using oxygen therapy at 15-25 liters/minute as an abortive and taking 10,000 IU/day vitamin D3 plus Omega 3 fish oil and the vitamin D3 cofactors as a cluster headache preventative provides the two safest and most effective methods of controlling your cluster headaches... 

Moreover, both are safe for you and your baby... The benefits of taking sufficient vitamin D3 supplementation during pregnancy... and after...  particularly if you intend to breast feed, are many...

Remember, that bump in your tummy is totally dependent on you...  It's snug, warm and it's got cable...  What could be better?

Take care,

V/R, Batch

I had clusters in the first trimester of both my pregnancies.   I am feeling your pain. I had the wonderful Dr.Kudrow manage my pain. I used oxygen but it doesn't always work for me (about 4 out of 5).
The first few weeks of my CH period, I used Darvocet. It just made me numb while my head hurt. Then we made the decision to use Imitrex.  I tried to use it only once a day. So we did, for about 5 or 6 weeks.
We monitored the baby with weekly ultrasounds. I also had an amino (preggers at age 37).
Both babies were born with no issues. My pregnancies were 2 years apart. Healthy weights, appetites, growth rate, etc. they are now 7 & 9. Still no issues.
This was a tough decision for me and my husband. I'm sure it must be difficult for you too. You need to do what is best for you in your situation.  Just make sure your OB and Neuro are communicating.

Hi Jennifer,

I'm 27 weeks pregnant tomorrow and am fortunate in that I have an occipital and supraorbital nerve stimulator which definitely helps.  I did have horrible clusters from weeks 9-14, but now just a few times a week - much better!  I go every 1-2 months to my neurologist to get supraorbital nerve blocks, and I'm not on any prevents and do not take any meds to abort.  I have taken chlorpromazine (thorazine) a total of 5 times during pregnancy after it was okay'd by my high risk OB - it is sometimes used for hyperemesis.  Otherwise, I've done ok!  In the first 16 weeks, my neuro did lidocaine only nerve blocks and since week 16, I've gotten lidocaine and bupivacaine.  I was definitely going monthly until last month when I decided to skip because I needed rest and was run down!  Just went this morning.  The best thing is that you may hit around week 14 and find they lighten up.  I was skeptical of that (I'm primary chronic), but that's what happened!  Hang in there!!!

PF Wishes,
Carrie