Paolo
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I am offering up my experience of cluster headaches over the last 23 years, which has gone from absolute despair to a state now where I am in control of them and can go through cycles without any headaches at all. I am doing this in case it can help someone who is somewhere on the same path as I was.
This is necessarily quite a long post, I apologise for that.
My headaches started at the age of 21 and were misdiagnosed for about 4 years, till I had the good fortune to see a prominent neurologist who knew exactly what I had.
My pattern was 2 cycles per year, lasting 6-8 weeks, with 1-2 headaches per day (but not waking me in my sleep). The headaches in my 20s were terrible, at the peak of each headache I would always think about suicide to stop the pain. The neurologist put me on lithium, oxygen and ergotamine inhaler.
Ergotamine is in effect a strong painkiller to take when a headache is starting. For me it could sometimes head off an attack , sometimes not. Lithium is traditionally an anti-depressant which levels out your moods. Oxygen did not help me but that is atypical I think.
I found that lithium changed me, by removing both the highs and the lows from daily life, it made things just flat and rather joyless. Although lithium and ergotamine were effective in reducing the number of headaches, the key for me was that they were just putting off the inevitable, and when the headache did come, it was stronger than before. It was like the medication was a dam that held back the pain until the dam could not hold any more.
I tried various alternative options: acupuncture, applied kinesiology, craniology, dietician, aromatherapy, something to do with pineapples I seem to remember. Nothing made a noticeable difference.
Eventually my attitude to cluster headaches changed. I had had enough of fighting it, of being angry about it. Where I live in France now there is a strong wind, they say it can drive a man mad. But trees and plants survive it very well and they say here that you have to bend with the wind. like the trees, not fight against it. This is more or less what happened to me with headaches. Instead of thinking of headaches as something from hell, it became an old friend come to visit (I know that this sounds very counterintuitive). Instead of thinking ‘why me?’ and 'when will this end?', I thought of it as a condition that has to be managed, not beaten.
I stopped taking any medication about 12 years ago. The cycles remained as before, but the headaches became less severe, I think because I accepted them. I had the sense that my body wanted to have its say, and so I let it.
8 years ago I started to go through cycles with very few headaches, and then even none at all, just the usual feelings you get that tell you you are ‘in season’. I assumed I was ‘cured’. The neurologist who diagnosed me had told me that the condition clears up in middle age for some sufferers.
But I wasn’t cured, I still got cycles with headaches. Occasionally during a headache I would get angry and writhe, despair, try to dismantle my head, like the old days. But usually I sit in a dark and silent room (the bathroom) and try to be calm, to pay attention to my breathing, and think about the right things. What are the right things? For me it is hit and miss, I tend to spin through different images, impressions, people, sounds, movements, some of them increase the pain, but then I fall on one that sort of puts the pain to one side and gives me relief. This is like the first step on the ladder. If I can follow that up with another good thought, it is like another step up, until the headache will ebb away to a long tail, or sometimes just blow out altogether if it has not gone too far in. I suppose what I do is akin to meditation, but I don't know enough about that to say.
Generally speaking, if the headaches of my 20s, all drugged up, were 10s, the ones I have now are 5s and 6s. Is this because I gave up on medication and stopped fighting it? I don’t know, it could just be the course of the condition. But I do think that going 'bareback' was the key.
After 23 years I actually think now that the reason I get cluster headaches is to stop me drinking alcohol for the cluster periods. Alcohol has always been the worst trigger, but the pattern the last few years has been that if I stop drinking as soon as I get the signs of a cycle coming, I go through that cycle headache-free. But if I try to carry on drinking just a little longer, for example if we have friends staying I have done it, then the cycle will be a typical one full of headaches.
So my experience distils to two suggestions for cluster sufferers whose experience may in some way mirror mine: - Try the no-medication approach, but coupled with an attitude of accepting and working out the pain rather than fighting it. The idea may seem abhorrent, but my thinking was: it can’t get any worse than it is. - Try not drinking any alcohol during a cycle, and stop drinking as soon as you feel the onset of a cycle.
I realise that there is an unknown, wide range of causes, reasons, triggers and possible remedies for this condition, and in most instances my advice is of no relevance, but I offer it in case it strikes a chord with a sufferer and may offer an approach that makes life more liveable.
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