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Posted by Bill McCuistion ( on October 05, 1999 at 00:32:59:

In Reply to: Imitrex posted by Chris on October 04, 1999 at 10:07:18:

Like many, I am sure, I keep a small stash of Imitrex because I never know when the cluster-bout will begin. During this bout my insurance company changed and they have really tried to ration my injections. It was barely enough when I was getting 1 attack a day. The tablets don't seem to do anything for me and the nasal spray is hard to use when my sinus is clogged due to the cluster. Two weeks ago, when the attacks started to be 2, 3 and 4 times a day, I went back into my refrigerator and found some old-style injections which had expired in 1997. I thought about it for a long time, 30 minutes or so. Are they safe? Would they even be effective? More effective? I couldn't recall any particulars as to exactly why I couldn't use them even though they were 26 months out of date. My thought process was that these particular injection kits had been in the produce drawer of my refrig since I bought them. Push come to shove, I knew that I would use them. That's why I had kept them.

Today, I live alone. CH is part of the problem. My wife of 8 years lives accross the street and two doors down. I used to live there. A month after we got married my first really bad (public) cluster round started. Public, because I don't know how long I had had clusters before we were married. I used to black-out during these attacks, as there was not much I could do about them. I didn't even realize I was doing it until we got married. She freaked. I got depressed and had a little mini-breakdown which lasted maybe 3 months. To this day she has sympathy for my CH condition, but no respect for me as she sees me as weak and pathetic. She recalls the CH bout as one of the key factors in the demise of our relationship. We have been separated for two years now. We talk and try to be nice, but it is a really big hassel. When I knew this bout was not going to go away easily, I asked her if things got really bad, like they had in 1991 and 1996, would she take me to the ER, if I asked her to. She said she would, but I knew there would be a price to pay. See, I know they mostly come at night and a trip to the ER is a multi-hour event. That would really interfere with her small business. I am not really high in her priority list today. She will make sure that I have some meds, but she doesn't want to get too involved, as she is neurotic and not sure that she won't catch CH from me. I am sure that I have used a lot of favors for her support, but she will not accept my appreciation. Anyway, this is only background and only obiquely CH-related.

In any case, the alarm-clock went off about 10 days ago, during the night, and due to the fact that I sleep very soundly, I awoke with a 8-ish attack. I took the old injection. Had to focus on how it worked, but like ridding a bicycle, it came right back. I always give the injection with my right hand into my left sholder. The injection worked well enough to stop the shaking which accompanies my attempt to block the pain.

Now, a week and a half later, I have a bruise where THAT injection was given. This is the only time that I can recall having a bruise about the size of a quarter due to an Imitrex injection.

I have about 3 more of these old-style, 1997 vintage, injections left. It may not be wise to use them, but that is the way it is.

Tip: When the insurance company tells me that I can only have so many in a week and I know that I will require more, I have found that these two strategies work: (1) Remind them that the alternative is an ER visit, which will run them a whole lot more money, and not be any more effective than I can do for myself if they fill the Rx; and/or (2) Indicate that I am going out of town, which is usually more close to the truth than I wish to think about, and that an out-of-town ER visit is even more than the one at home. They usually do the right thing when presented with this logic.

Finally, I now have a small supply of Rx which should last for several days, at least.

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