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Coped when it was just me, now I have a baby... (Read 764 times)
Sarah C
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Coped when it was just me, now I have a baby...
Dec 17th, 2011 at 1:59pm
 
I'm a 31 year old female based in Surrey in the UK - although I'm originally from South Africa. Started getting cluster headaches in my last few years at high school and can remember cycles throughout every major milestone in my life - high school, university, my first professional job, my current job... and four and a half months ago I gave birth to my beautiful daughter. It's been virtually 3 years to the day since my last cycle and last week I woke up at 3am with that feeling of dread - the headache itself wasn't that bad but I knew what was coming. Weeks of anticipating the next headache, suffering through the pain, feeling that nobody - including my husband - really knows just how bad it feels... that feeling that your eye is going to pop out of your head, that your ear is going to explode through your temple and that your neck and shoulder have gone 10 rounds as a heavyweight's boxing bag.

Then it hit me that this time would be very different - no way could I lock myself in the bedroom for hours at a time, speaking to no one and simply rocking back and forth with my head in my hands and tears of pain and frustration rolling down my cheeks... I HAD A BABY TO THINK ABOUT! A baby who I am still breastfeeding.

No happy ending to this story - yet. Getting the headaches at least twice a day and they're getting steadily worse. Went to see my GP who literally shrugged his shoulders - apparently there's nothing - aside from paracetamol - that I can take while I'm still breastfeeding. So faced with the choice of suffering through unbearable pain so that I can continue breastfeeding or putting my baby on formula and then attempting a treatment plan mid-way through a cycle...

So tired and so so low... managing to feed Emma and then handing her over to my parents to look after her while I head for the bedroom - if not to struggle through a headache, then to try and catch up on sleep missed the night before. Miss my little girl...

What happens when I head back to the UK and there's no grandparents on hand to babysit?

An interesting aside - my last cycle started in January 2009 virtually as I got off the plane in England from a holiday in South Africa. And this cycle started a few days after landing in South Africa for another holiday (introducing Emma to her grandparents) from England... change in climate, change in altitude, change in north/ south hemisphere??? Can't understand why these trips are different - have been back between the two countries on a number of occasions during the last 3 years with no problem.

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Bob Johnson
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Re: Coped when it was just me, now I have a baby...
Reply #1 - Dec 17th, 2011 at 2:17pm
 
You make no mention of any kind of medical care for the Clusters. Clearly, the first step. (I take it you are un the UK full time??)

Local docs in England appear, from the messages we get here, are rather limited in their knowledge/skills with headache. I understand that you have, by law, the right to ask for referal to a headache clinic, by-passing the usual referral routine.

You have an excellent support group which can give all types of help dealing with your healthcare system:

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including how to get a referral to a headache clinic.

See the PDF file, below, for an idea of the kind of treatments you should expect to get from a well trained doc.
----
Send this abstract as a good introduction to Cluster--for your learning:




Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register (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]
====
Because the area of headache is more complex than is generally appreciated, I'd strongly urge to get moving on finding a headache specialist: again, the support group can help you.
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Bob Johnson
 
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wimsey1
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Re: Coped when it was just me, now I have a baby...
Reply #2 - Dec 19th, 2011 at 7:12am
 
I'm not sure about the use of all meds while nursing...that will have to come from others on the board, and/or your OB-GYN. But, I do know your best intervention is O2, and that should pose no problem whatsoever. It's the wonder of O2 that it does work to abort and shorten the duration and intensity of the hit, and it is not a drug. I would check this out reading the Oxygen info link at left, print it out, and bring it with you to your next visit. And if it is OK, get it as soon as you can. I'd also begin making a list of every effective intervention listed here, and once you are able, try them under you dr's care. Mostly, though, you need a good headache doc, one who doesn't merely shrug off the terror and terrible pain you are enduring. God bless. lance
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Bob Johnson
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Re: Coped when it was just me, now I have a baby...
Reply #3 - Dec 19th, 2011 at 3:36pm
 
This abstract is from a major medical journal (in the US).
=

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
========
Print this and use to discuss your treatment with the doc.
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Sarah C
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Re: Coped when it was just me, now I have a baby...
Reply #4 - Jan 3rd, 2012 at 5:21am
 
Thank you SO SO much for the very useful info above. I am back in the UK now and have a GP's appointment on Thursday morning - here's hoping I can get the ball rolling on this. Going to give the support group a call too today.

Cycle continues... argh!
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lionsound
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Re: Coped when it was just me, now I have a baby...
Reply #5 - Jan 4th, 2012 at 7:31am
 
Hi Sarah,
My youngest son just turned six and when I was nursing him, I used Oxygen ONLY because I did not believe that Imitrex (maybe called imigran for you) was safe for my baby in the breast milk. I would have had to pump and then dump the milk, so that the baby didn't get the medicated stuff, and that just didn't work for me. I also didn't want my infant to get other pain meds either in the breast milk.

I'm sorry you are hurting. You have just got to believe that it is a very temporary situation you will get through it! You need to talk to your pediatrician as well as a headache specialist and decide what is best for you and your baby.

Some docs will say that the imitrex and is okay and I just don't buy that because of how it makes ME feel i can't imagine that stuff in a tiny baby. I hope OXYGEN works for you.

may you be pain free,
Rori


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