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roland88

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First Attempt with Imigran
Sep 12^th, 2009 at 8:26am

Hi gang, this is my first post. I am currently going through my 4th cycle. Last one was 2 years ago, then once a year for the couple of years before that.

Each cycle lasted around 4 weeks and hit me at 2am in the morning.

This time it is a little different - worringly I am getting hit twice a day, one at around 8.30pm and the nightly 1am. Also this time the shadow is more pronounced.

Rather than sitting through the 4 weeks this time, I cracked and went to the doc with the aim of trying Imitrex Nasal. I ended up with Imigran which I believe is the same. (Australian equivalent?)

The 8pm CH reared it's ugly head and I tossed up with the missus whether to ride it out or risk the "possible adverse effects" - possible cardiac arrest etc....

In any case 5 minutes since the beginning of the CH build up I pealed open the blister pack and took the dose.

I sat there and watched the clock expecting no relief, well I was totally amazed - 4 minutes after the dose the demon reversed and disappeared. My first abort!

It's been 2 hours and I did go through a slight hot flush and sweaty period, but right now no pain, no shadow - nothing other than a slightly stiff neck.

At $10 a hit it's not cheap, so have to toss up when to use it. I am a little worried about using more than 1 dose a day. Also I ended up with a dual blister pack of 20mg and 4 more repeats on the script.

I think that there is a smaller dosage so if I need to more I may end up trying to get the smaller size that way I can spread the same dollar cost over a longer period.

I would be interested in hearing comments on the different dosages and what works with others.

In summary I am feeling pretty happy about giving the beast a good smack in the mouth!

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Bob Johnson

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Re: First Attempt with Imigran
Reply #1 - Sep 12^th, 2009 at 8:54am

Given your frequency of attacks, you do not mention using a preventive med. If you are not, get back to the doc.

Trying the smaller dose is worth it but your body will be the "decider" as to which to use.

Be careful to not delay taking the Imitrex at the first sign of an attack. Delay often reduces effectiveness markedly, ergo, waste of money.
=====
HERE ARE TWO MAJOR DOCUMENTS WITH RECOMMENDED TREATMENTS FOR CLUSTER HEADACHE, ONE FROM A U.S. PHYSICIAN, THE SECOND FROM EUROPE.
_________________________________________
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Here is a link to read and print and take to your doctor. It describes preventive, transitional, abortive and surgical treatments for CH. Written by one of the better headache docs in the U.S. (2002. Rozen)
================
Treatment guidelines from Europe

------
A. May, M. Leone, J. Áfra, M. Linde, P. S. Sándor, S. Evers, P. J. Goadsby:
EFNS guidelines on the treatment of cluster headache and other
trigeminalautonomic cephalalgias.
European Journal of Neurology. 2006; 13: 1066–1077.

Download free full text:
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(Thanks to "cluster" for link.)

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Bob Johnson

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roland88 CH.com Newbie Offline I Love CH.com! Posts: 19	Re: First Attempt with Imigran Reply #2 - Sep 12^th, 2009 at 9:13am Thank you for the link to the documents, I am yet to read the 2nd one, but the first one has me wanting to go and get some melatonin tomorrow. The doctor had only ever had 1 cluster patient before me, so I probably knew more about it than he did.
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Marc Ex Member Gender:	Re: First Attempt with Imigran Reply #3 - Sep 12^th, 2009 at 9:30am Oxygen
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Bob Johnson

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Re: First Attempt with Imigran
Reply #4 - Sep 12^th, 2009 at 10:53am

So, let's educate you doc. Many of us have had to do so as a form of self-protection!
========

Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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(Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]

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« Last Edit: Sep 12^th, 2009 at 10:54am by Bob Johnson »

Bob Johnson

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bejeeber

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Re: First Attempt with Imigran
Reply #5 - Sep 12^th, 2009 at 4:28pm

Having to educate the doc is pretty routine for a lot of us I'm afraid.

Hi flo rate O2 as outlined on the site here could do you a world o' good! You are just not going to find any ~~bozo~~ doctor who will know jack about it though.

Imitrex: Personally I've taken a few metric ton loads of the stuff since it first became available and although initial reports of some small issues with it such as coma and death caught my attention, I'm not having side effects, not worrying about them, and continue to use it when needed.

My impression is that Imigran is the name given to Imitrex when marketed outside the US/Europe (?). At least I know that's what they call it in Mexico,and I believe it's the exact same stuff.

$10 each huh? Wow that really adds up. Expensive. NOT! What is that your insurance co-pay or something??!!

Imitrex injections are the main choice of the informed/battle hardened triptan using clusterheads around here as far as I can tell - they are certainly my first choice. If your attacks become more difficult to abort, check out the imitrex tip also on this site that details how to very effectively use half injection doses, thereby cutting any expense/risk in half.

Without insurance, a generic form of the injection would cost me $87 here, $112 (per injection) for brand name. Insane.

There is some concern about the potential for imitrex use to start causing you to have more frequent/rebound attacks BTW, hence the advisability of looking into O2 and preventatives to add to your arsenal for max counter assault on this beast.

As someone who "only" gets 1 or 2 attacks a day, and who can easily abort one with the Imigran inhaler in 4 minutes, you might even be able to use this free method for aborting an attack for awhile: crank the car air conditioning up, put your shnoz right up to a vent, and breathe with intent of freezing your inner skull for 10 -15 minutes. It gives me a pretty good ice cream headache, which is vastly preferable to a cluster of course, and if I'm in a 1-2 a day headache mode (usually my first week) I can abort attacks pretty consistently this way.

Anyway I'm glad your attacks aren't particularly severe (just reading that into it, considering how you actually hesitate to abort an attack if it's going to set you back ten bux) Cheesy

Maybe you're just particularly thrifty, or don't have a credit card. Grin

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« Last Edit: Sep 13^th, 2009 at 3:26pm by bejeeber »

CH according to Bejeeber:

Strictly relying on doctors for CH treatment is often a prescription that will keep you in a whole lot of PAIN. Doctors are WAY behind in many respects, and they are usually completely unaware of the benefits of high flow 100% O2.

There are lots of effective treatments documented at this site. Take matters into your own hands, learn as much as you can here and at clusterbusters.com, put it into practice, then tell this CH beast Jeebs said hello right before you bash him so hard with a swift uppercut knockout punch that his stupid horns go flinging right off.

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roland88

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Re: First Attempt with Imigran
Reply #6 - Sep 12^th, 2009 at 8:29pm

OK, well after my first abort at 8pm I went to bed at 12.30am, not only didn't my 1.00am monster not turn up, but I also couldn't sleep - I laid awake until at least 4am. My wife tells me I did get some sleep.

I ended up with my first morning CH's whilst still lying in bed, 1 at 8am and another at 9.30am (it's 10.20am now). Both of these CH's were very mild - nothing more than an annoyance.

I am up and about now, first coffee on a Sunday morning feeling a little tired, almost no shadow.

So just wondering why the Imigran killed my sleep???

Anyway, first night in 15 days without a nightly visit, so far I would say the difficulty in sleeping is better than the demon disrupting my sleep.

Let's see how day 16 plays out....

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roland88

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Re: First Attempt with Imigran
Reply #7 - Sep 12^th, 2009 at 8:35pm

My Chinese wife came up with this link: Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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Re Chinese Herbal CH Treatment:

Quote:

CLINICAL SUCCESS IN CHINA Chinese herbal doctors have reported some successful applications of these herbal combinations. During observation on 150 patients receiving treatment with herbal remedy, 126 cases were judged as healing (full recovery and symptom free), 15 cases other significant improvement. Physicians judged the clinical efficacy to be good or excellent in 94.0%. Check the table below for details.

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roland88 CH.com Newbie Offline I Love CH.com! Posts: 19	Re: First Attempt with Imigran Reply #8 - Sep 12^th, 2009 at 8:45pm She found this one as well: Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to or Quote: Kudzu found effective for relief of cluster headaches Additional reading can't hurt
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Marc Ex Member Gender:	Re: First Attempt with Imigran Reply #9 - Sep 12^th, 2009 at 9:06pm Take a shortcut and read more on this site. You will not find more experience/trials/tribulations/successes/failures with CH's anywhere else.
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roland88 CH.com Newbie Offline I Love CH.com! Posts: 19	Re: First Attempt with Imigran Reply #10 - Sep 12^th, 2009 at 9:23pm Marc wrote on Sep 12^th, 2009 at 9:06pm: Take a shortcut and read more on this site. You will not find more experience/trials/tribulations/successes/failures with CH's anywhere else. Very true, but if I can stumble on something additional, then it will add to our resources
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Lawrence

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Re: First Attempt with Imigran
Reply #11 - Sep 12^th, 2009 at 10:09pm

roland88 wrote on Sep 12^th, 2009 at 8:45pm:

She found this one as well: Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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Additional reading can't hurt

first thing to really catch my eye.....
Cheesy

"If you or someone you know is one of the unfortunate 0.1% of the population who suffers from cluster headaches, take heart:"

LOL Grin

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Weapons Check:
O2 grenades--Verapamil hollow points--
Prednisone Sniper Rifle--Rivea corymbosa Nerve Gas

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JustNotRight

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Re: First Attempt with Imigran
Reply #12 - Sep 12^th, 2009 at 10:32pm

Marc wrote on Sep 12^th, 2009 at 9:06pm:

Take a shortcut and read more on this site.

You will not find more experience/trials/tribulations/successes/failures with CH's anywhere else.

Kudzu has helped lower the number of CH hits I get!! Been on it for a couple of months. Wink

Where did I learn about it??? Here. Did some research on it on my own and decided to try it. Cool

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An eye for eye only ends up making the whole world blind.
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If you are going through hell...Just keep going

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Lefty

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Re: First Attempt with Imigran
Reply #13 - Sep 13^th, 2009 at 4:36pm

I'm kinda of track here....but for those of us that don't like giving ourselves those imigran (imitrex) injections I see they are bringing out a needle free version...or it may already be available...!

I would go with Oxygen myself, works faster and doesn't mess with your system.. Wink

Below is a link for new drugs in the pipeline for Migraine and Clusters.

Lefty..!

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« Last Edit: Sep 13^th, 2009 at 5:50pm by Lefty »

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drug_watch.pdf (Attachment deleted)

"When money's tight and is hard to get
And your horse has also ran,
When all you have is a heap of debt
A PINT OF PLAIN IS YOUR ONLY MAN."
— Flann O'Brien

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Lawrence CH.com Veteran Offline There WILL be a cure Posts: 163 Merrillville, Indiana Gender:	Re: First Attempt with Imigran Reply #14 - Sep 13^th, 2009 at 5:20pm hey lefty the link says its an expired session
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JustNotRight

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Re: First Attempt with Imigran
Reply #15 - Sep 13^th, 2009 at 5:23pm

Lefty wrote on Sep 13^th, 2009 at 4:36pm:

I'm kinda of track here....but for those of us that don't like giving ourselves those imigran (imitrex) injections I see they are bringing out a needle free version...or it may already be available...!

I would go with Oxygen myself, works faster and doesn't mess with your system.. Wink

Below is a link for new drugs in the pipeline for Migraine and Clusters.

Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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Lefty..!

I saw that too about the needle free version but haven't seen anything "NEW" on it most of the reports on it are older by at least a year if not two. Maybe it's still in development.

<EDIT>
Wait hold the phone just found a new 2009 article
here Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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« Last Edit: Sep 13^th, 2009 at 5:26pm by JustNotRight »

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An eye for eye only ends up making the whole world blind.
M.K. Gandhi

If you are going through hell...Just keep going

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Lefty CH.com Alumnus Offline Posts: 759 Gender:	Re: First Attempt with Imigran Reply #16 - Sep 13^th, 2009 at 5:52pm Try that link now entitled drug watch on previous post..! hopefully should work I'm a complete novice with puters.. Lefty..!
Back to top	"When money's tight and is hard to get And your horse has also ran, When all you have is a heap of debt A PINT OF PLAIN IS YOUR ONLY MAN." — Flann O'Brien IP Logged

AussieBrian

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Re: First Attempt with Imigran
Reply #17 - Sep 14^th, 2009 at 12:51am

G'day Roland, and welcome to the biggest un-fenced lunatic asylum outside of Canberra. As you've already discovered there's an absolute wealth of information here and most of the members are otherwise up-standing members of the community (but more about Chuck later).

The next premier of Westralia, the Rt Hon Barry-T-Coles put this link together some time back and it's an excellent resource as to Oxygen here in Oz. Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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Please consider it as it's a godsend to many and if there's any probs with the doc there are alternatives.

Another serious management technique includes avoiding triggers and, regrettably, beer is one of them. It seems to be related more to individual batches than just beer overall but, as a community service, I'm available to drink all your grog (saving you heaps of unnecessary pain) and I'll let you know later which batches you'd otherwise have been able to consume. There is no charge for this while you cover the freight.

Otherwise, just hang in, stay stong, and welcome home.

Cheers and beers,

Brian up north.

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My name is Brian. I'm a ClusterHead and I'm here to help. Email me anytime at briandinkum@yahoo.com

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cluster

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Re: First Attempt with Imigran
Reply #18 - Sep 14^th, 2009 at 7:05am

Bob Johnson wrote on Sep 12^th, 2009 at 8:54am:

Treatment guidelines from Europe

A. May, M. Leone, J. Áfra, M. Linde, P. S. Sándor, S. Evers, P. J. Goadsby:
EFNS guidelines on the treatment of cluster headache and other
trigeminalautonomic cephalalgias.
European Journal of Neurology. 2006; 13: 1066–1077.

Download free full text:
Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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Hello all,

the EFNS Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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has a new web page design. The link to the European CH Guideline: EFNS guidelines on the treatment of cluster headache and other trigeminal-autonomic cephalalgias (free PDF) has been changed to

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pf wishes,
Friedrich

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« Last Edit: Sep 14^th, 2009 at 7:07am by cluster »

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