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hello to everyone. newbie looking for answers (Read 740 times)
cheezburger
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hello to everyone. newbie looking for answers
Jul 29th, 2013 at 1:00am
 
Hey, I was diagnosed with ch fall of 2006. I am chronic, don't have  attacks at night. They all start in the daytime and  continue into the night. I have lots of shadows starting on Wednesdays going till Friday when it goes kip 8-9 and stays till Sunday evening usually getting a break monday and tuesday.
My biggest question to everyone is; does anyone have their eyes roll into the back of their head?
I'm fully aware that this is happening and I know where I am at, my body doesn't go rigid, like a seizure and if someone shakes me I'll come back. I have had this happen three seperate times over the past 7 years.
I saw a nuero who diagnosed me. But scheduling conflicts kept me from going back. I have a good gp that wants to help and understands ch.
Meds; verapamil, no help. Indomethacine, no help. I am going next week to talk to her about o2 and imitrex. Any other thoughts or suggestions are appreciatted.
By the way: male, 49, long haul trucker
Thanks
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wimsey1
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Re: hello to everyone. newbie looking for answers
Reply #1 - Jul 29th, 2013 at 8:46am
 
cheezburger wrote on Jul 29th, 2013 at 1:00am:
My biggest question to everyone is; does anyone have their eyes roll into the back of their head?

Meds; verapamil, no help. Indomethacine, no help. I am going next week to talk to her about o2 and imitrex.

No, that is definitely not a CH symptom reported here. Don't know what that is but despite your awareness it still has the sound of a seizure.

You mention some meds but don't mention the doses. For example, verapamil is usually prescribed in the range of 240mg/day. That is fairly useless for us. We need 460-980mg/day before it becomes effective. What were your doses?  In the meantime, good luck and God bless. lance
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cheezburger
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Re: hello to everyone. newbie looking for answers
Reply #2 - Jul 29th, 2013 at 1:48pm
 
Thanks for the reply. I am not sure of the dose of verapamil, it was prescribed back when first diagnosed.  Indomethacine is 25 mg
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wimsey1
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Re: hello to everyone. newbie looking for answers
Reply #3 - Jul 30th, 2013 at 7:42am
 
If indomethacin is going to work, it usually works right away. Its use is for a rather narrow diagnosis called indomethacin specific headache. Verapamil, in high doses, is a much broader prescription for CHs. blessings. lance
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Bob Johnson
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Re: hello to everyone. newbie looking for answers
Reply #4 - Jul 30th, 2013 at 8:40am
 
Most docs, and this includes neurologists, receive so little education in treating complex headache disorders, that seeing a headache specialist would be the best route, if at all possible. (Your present meds & dosing suggests this is an issue with your present doc.)

Seethe PDF file, below. Gives you a good overview of current treatments for Cluster.
===
LOCATING HEADACHE SPECIALIST

1. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

2.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

3. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register; On-line screen to find a physician.

4. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

5. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to Login or Register NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
=========

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]
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Bob Johnson
 
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