Lauren,
I’ve been on travel so I’m late in responding to your post. From your description, it sounds like your husband is using the welder's O2 regulator effectively. There are however, two things he can do that may help improve the efficacy and time to abort when using oxygen therapy, or at least make the oxygen therapy work more consistently.
The first is a method of oxygen therapy, procedures and a breathing technique that supports hyperventilation with 100% oxygen. The second is controlling arterial pH to keep it from going lower than normal with a regimen of mineral supplements and vitamins.
Before I go into an explanation of these two topics, I need to make the following obligatory statement:
I'm not a doctor... (I did stay in a Holiday Inn a few years ago.) I'm retired so I've been able to devote much of my time over the last six years to study both our disorder and the effects of oxygen therapy at higher flow rates since I turned chronic in 2004. That was when I first started using oxygen therapy to abort my cluster headaches. I've also had the opportunity to meet with several of the top neurologists here in the US and Europe treating cluster headache sufferers to discuss these two regimens of treatment.
All of these neurologists agreed that higher oxygen flow rates appeared to offer greater efficacy and shorter abort times with greater safety than other prescribed abortives. One of them, Dr. Todd Rozen, is about to start a clinical trial of this method of oxygen therapy dispensed with a demand valve so we should have evidence based proof in a few months that could change the way oxygen therapy is prescribed today.
I'm also a retired Navy pilot with over 3,000 hours flight time in fighters and all of that flight time was spent breathing 100% oxygen from the catapult shot to arrested landing aboard ship on missions averaging two hours in duration. During actual combat or training missions involving high G-force maneuvers, I would frequently consume that 100% oxygen at flow rates at or above 50 liters/minute.
Moreover, repeatedly breathing 100% oxygen several times a day at flow rates greater than 15 liters/minute is very safe with no known long term side effects. As proof, consider the fact that Navy and Marine Corps pilots flying tactical aircraft, have been breathing 100% oxygen from takeoff to landing for more than 70 years and they still do so today when flying fighter and attack aircraft costing more than $30 Million. NASA astronauts breathe 100% oxygen for up to 4 hours when suited up for EVAs. All of them are required to have annual flight physicals with chest X-Rays so if there was a problem, it would have shown up long ago.
I’ve used oxygen therapy at flow rates that support hyperventilation on all my cluster headaches since 2004 and I’m still here at age 66.
Finally, I'm providing the following discussions for information purposes only. You should consult with your primary care physician or neurologist before attempting either of the two regimens discussed in this post.
We've tested the following method of oxygen therapy and procedures in an informal proof of concept pilot study and found them to be very effective in achieving fast and consistent aborts with no adverse reactions.
The goals of this method of oxygen therapy and procedures are two-fold: (1) hyperoxia, elevating the arterial oxygen content above normal, and (2), hyperventilating with 100% oxygen in order to cast off CO2 from the lungs faster than the body generates it through normal metabolism. This elevates arterial pH and results in another respiratory condition called respiratory alkalosis.
Both of these conditions induce vasoconstriction, and when that occurs in and around the trigeminal nerve these two regimens of treatment act as very rapid and very effective abortives stopping the cluster headache with no side effects.
The first rule of oxygen therapy is to start it early. If your husband is awake, he needs to start on the oxygen as soon as there are any indications of an approaching attack. If the attacks come while sleeping (this is most common), start on the oxygen ASAP after waking up! The longer he waits, the higher the pain will build and higher pain levels mean longer abort times.
The following procedure works best if standing to give the diaphragm a full range of motion to better ventilate the lungs. If used properly, these procedures can make your husband feel a little dizzy. I've used them for 6 years and have yet to fall from being too dizzy. I usually lean against a wall. If your husband feels too dizzy leaning against the wall, have him take a seat.
There are three phases to this procedure: Clearing Nitrogen, Fast Hyperventilation, and Slow Hyperventilation.
The purpose of the first phase is to start clearing nitrogen from the lungs and also to let the lungs adjust to the dryness of the oxygen. Start this phase with the oxygen at a moderate flow rate inhaling at a comfortable rate as fully and deeply as possible (this should take 2 seconds), then exhale as completely as possible for 4 to 5 seconds. This should work out to an oxygen flow rate of 25 to 30 liters/minute.
Exhaling as completely as possible is very important. When it feels like my lungs are empty after exhaling normally, they're not, so I do an abdominal crunch or single coughing maneuver and hold the chest and abdominal squeeze for a few seconds longer while exhaling. This breathing technique will squeeze out another half liter or more of residual breath. This is called forced vital capacity breathing. As this last volume of breath has been in the lungs the longest, it contains the highest concentration of CO2.
The purpose of hyperventilating with 100% oxygen is to pump out CO2 faster than the body generates it through normal metabolism, drive up the arterial pH, and hyper-oxygenate the arterial blood.
Coughing is normal during this first phase. It can be caused by the dryness of the oxygen and will pass in 10 to 15 seconds as the lungs adjust to the dryness. Coughing can also be caused by atelectasis. Atelectasis is a condition characterized by an uncontrollable urge to cough and it occurs when small local areas of the lungs have collapsed alveoli that start to re-inflate with deeper breathing as the lungs fully inflate. Atelectasis can occur normally during sleep where the level of lung ventilation is lowest. Fortunately, coughing re-inflates the alveoli very rapidly and the coughing should clear in 10 to 15 seconds.
The purpose of the second phase, Fast Hyperventilation, is to voluntarily hyperventilate as fast as possible in order to push the circulatory and respiratory systems into respiratory alkalosis. This pushes arterial pH slightly above normal causing vasoconstriction and that makes the cluster headache abort happen faster.
To do this phase properly you'll need to hyperventilate at a respiration rate of 20 complete breaths per minute at vital capacity tidal volume of 3 liters inhaled with each breath. If you use a 0 to 60 liter/minute regulator, the oxygen flow rate during fast hyperventilation will be 60 liters/minute
Continue hyperventilating at this rate for one minute or until you feel the symptoms of paresthesia whichever occurs first. The symptoms of paresthesia include a slight sensation of tingling or prickling of the fingertips, lips, or back of the neck and are frequently accompanied by a slight dizziness.
Fast Hyperventilation is hard work and very tiring, but the payoff is worth it.
After one minute of Fast Hyperventilation or when you start feeling the symptoms of paresthesia whichever occurs first, slow the flow rate to support Slow Hyperventilation at a respiration rate of 12 complete cycles/minute with a forced vital capacity tidal volume (inhale for 2 seconds and exhale for 3 seconds with an abdominal crunch to squeeze out the last volume of residual breath. This should work out to an oxygen flow rate of 40 liters/minute.
The Slow Hyperventilation phase requires less effort and is easy to sustain until the abort to a pain free condition. If the above procedures are accomplished correctly, the user should start feeling the pain level off or start dropping after 2 to 3 minutes depending on the headache pain level at the start of therapy.
Data from the informal pilot study of this method of oxygen therapy as an abortive for cluster headaches where 7 CH'ers collected data on 366 aborts, indicated an average abort time of 7 minutes for cluster headaches at pain level 3 through 9. We also found a direct relationship between pain levels and abort times. In short, the lower the pain level, the faster the abort with this method of oxygen therapy. For example, a cluster headache at Kip-3 to Kip-4 took an average of 3 to 4 minutes to abort while a cluster headache at Kip-7 to Kip-8 could take an average of 9 to 12 minutes to abort.
The important thing to remember about oxygen therapy is that it is only an abortive and not a preventative. If you're averaging a cluster headache every two hours, oxygen therapy will not change this frequency nor will it prevent cluster headaches... but it will make them more manageable. Moreover, the confidence of knowing you can make the pain go away reliably does wonders for getting out of the typical funk we've all suffered when getting hammered 6 to 8 times a day/night. Knowing you can abort cluster headaches reliably all but eliminates the fear and anxiety of the next attack.
Having said all this, there are also times when the above method of oxygen therapy will not produce rapid aborts. There can be a number of reasons for this, but the best explanation for this increase in abort times can be attributed to a lower than normal arterial pH. In other words, the arterial blood has too much acid.
This low pH condition can also be caused by metabolic acidosis or a renal insufficiency (low kidney function) and it doesn't take too much of a shift to a lower pH to trigger more frequent and more intense cluster headaches. This condition can also be caused by diet high in acid forming foods or another co-morbid medical condition that lowers arterial pH. See the chart at the bottom of the following link for a list of acid and alkaline forming food types…
Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to
or
I turned chronic in 2004 after 11 years of episodic cluster headaches, but I still go through high and low cycles. During a high cycle I average 3 attacks a day/24 hours with up to 8 attacks a day during the peak part of the high cycle. During low cycles I typically average 3 to 4 attacks a week.
It didn't take long for me to discover that when I went into a high cycle, if I started pushing 3 to 4 calcium citrate tablets a day that contained vitamin D-3, magnesium and zinc, I could shorten the high cycle and reduce both the frequency and intensity of my attacks. I also started taking 3 to 4 Omega-3 fish oil gel caps a day in 2007 to help combat a high cholesterol condition brought on by the side effect from an immunosuppressant called rapamune (sirolimus) that I was taking as a part of a clinical trial for my eyes at NIH.
The Omega-3 fish oil and a diet high in alkaline forming foods with less red meat worked well to reduce my total cholesterol from 250 down to 170 while still taking the sirolimus. The biggest surprise was the Omega-3 fish oil also helped hold down the frequency and intensity of my cluster headaches.
A year ago I found that homemade lemonade also helped reduce the frequency and intensity of my cluster headache attacks during both high and low cycles. Last June when the temperature was in the 90s for most of the month, I started drinking Baja Bob's sugar free margarita mix with and without the agave (tequila) and found it worked even better than the homemade lemonade. It reduced the frequency of my low cycle cluster headaches significantly and allowed me to go two weeks pain free.
I suspected the extra citric acid in Baja Bob's sugar free margarita mix was the extra ingredient that increased its effectiveness as a preventative. I checked my saliva pH with pH test strips as an analog of arterial pH, and it was clear, the sugar free margarita mix had elevated my average arterial pH.
Why the regimen of 3 to 4 calcium citrate tablets and a couple glasses of lemonade or margarita mix that contain citric acid worked to hold down the frequency and intensity of my cluster headaches had me wondering for a while until I remembered some of my chemistry and found an article citing a British Journal of Anesthesia article titled "An oral sodium citrate-citric acid non-particulate buffer in humans" at the following link:
Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to
or
You'll see in this article that this regimen acts as a buffer on the stomach's gastric juices elevating the pH of the stomach contents from 2.0 to 3.9 and kept it at this level for 6 hours. As calcium citrate is a chemical analog of sodium citrate with very similar chemical properties, taking these mineral supplements along with lemonade or margarita mix was lowering the acid content of my stomach's gastric juices.
Moreover, because food passing through the small intestine must not have an acid content less than a neutral pH (7.4). When the stomach contents enter the lower part of the stomach called the duodenum, the pancreas dumps a large quantity of bicarbonate into the mix to elevate the pH of the contents up to neutral before they enter the small intestine.
However, when using this regimen, the stomach's contents are already at a pH of 3.9 because of the buffering action, and not at a pH of 2.0 from the hydrochloric acid the stomach produces as part of the digestion process. The bicarbonate solution injected by the pancreas elevates the pH of the food passing into the small intestines to a pH greater than 7.4 making it more alkaline than normal. As arterial blood picks up nutrients from the small intestine, it tends to take on the same elevated pH.
Now for another obligatory statement… Unlike oxygen therapy where there is a growing body of evidence-based medical research data from clinical studies on its effectiveness as an abortive for cluster headaches, the use of mineral supplements and vitamins as a preventative is still largely anecdotal. In other words, it’s in the same class as drinking Red Bull as an abortive or taking melatonin at night to get a good night’s sleep.
I though vitamin D3 and Omega 3 Fish Oil might be playing a role as a preventative for me. Because the temperature was above 90º for most of June I was clad in shorts and tank top while working our in the garden or watering then lawn a couple hours a day so I was likely generating lots of vitamin D3 from all the direct sunlight. I was also downing a couple glasses of margarita mix a day with and without the agave (tequila) and went pain free for nearly 3 weeks. Many of the top nutritionists say 10,000 IUs of vitamin D3 a day is not unreasonable as the body can generate that much with as little as 30 minutes exposure to direct sunlight.
To test his hypothesis, I stopped taking the calcium mineral supplement tablets with vitamin D3, magnesium and zinc and switched to 10,000 IUs of vitamin D3 and 3000 mg of Omega 3 Fish Oil a day on 5 October. At that point I was still in a high cycle with 5 to 6 attacks a night that aborted easily with high flow rate oxygen. The number of attacks at night dropped to zero by the morning of the 8th and I’ve been pain free ever since while using this regimen.
So what‘s the bottom line on the use of a regimen of minerals supplements and vitamins to reduce the frequency and intensity of cluster headaches? The answer is the only consistent thing about cluster headaches… they change and we’re all wired differently. What works for one of us as a preventative may not work for another, and the corollary: What works for one of us now, may not be as effective or may not work at all at a later date. That’s the nature of cluster headaches.
Having said that, oxygen therapy is likely the exception if the flow rate is high enough, it’s used early with properly functioning equipment, and there are no co-morbid conditions that prevent it from working.
Hope this helps.
Take care,
V/R, Batch
Home
Pages: 1
Oxygen Question and Update (Read 4104 times)
