Re: Newbie friend questions/THKX

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Posted by b montgom on September 25, 1998 at 19:24:56:

In Reply to: Re: Newbie friend questions posted by Doc Greg on September 24, 1998 at 14:42:17:

Hello, Doc G.
Thanks for taking the time and for your very informative, thorough reply.
Here are some further thoughts:
There seem to be two big aspects to CH problem:

1) Triggers
2) Bouts

I have read the data on the site page. It was helpful but did give rise to many of my puzzlements.
The CH bouts ³feel² like a heavily engraved, complex, multi-faceted group of processes located in the same general area and similar enough to be called the CH pain symptom. It involves the CNS, neurotransmitters and parts of the intercranial vascular system. Due to the location of CNS process origin in the hypothalamus, it is often associated with circadian rhythms. Results of an episode of CH pain bout show changes in serotonin levels and histamine levels (among other possible results).

This pattern seems to become a ³learned², typical, inured reaction cycle for CH people. Like those who are prone to chronic depression, the cycle is difficult to break. When I had a CVA five years ago it seriously changed the chemical ³soup² in my cranium (normal for strokes) and after enduring more than 6 months of the imbalance and finding it disturbing to my ability to return to work, I asked for help and was given Paxil. This worked just fine to give me a break from the processes (depression, emotionalism) resultant from elevated levels of serotonin. It only made sense to me that it might be possible that suppressing serotonin activity in general might help break the CH cycle which looked like it might be dependent on neurotransmitter activity. Too bad that my rather facile solution doesnıt work. Not helpful at all? Some of the more particular serotonin-controlling agents seem really scary in their side affects.

To break a bout by just blocking a part of one of the processes seems to be a highly desirable goal. Looks like different things work at different times for folks. I thought that studies had shown that lidocaine was effective, particularly as a drip under controlled circumstances and maybe with an enabler. Also thought, there, that inhaled lidocaine (done correctly) looked good as an agent to break up a bout. Too bad it doesnıt work. Things that chemically affect the vascular system seem not to work. Some seem to have success with caffeine treatment (if theyıre off caffeine) if itıs done very early in a bout.
Looks like it boils down to what works for an individual and that its better to use mechanical means (like the freezer or cold air, exercise , etc.) or relatively innocuous things like caffeine.
Also, it looks like TLC, stress-reduction and relaxation in general help to manage bouts.

To the trigger question:
Could it be possible that triggers (which can vary over time and may be combination, I gather) are nearly constantly present during a bout? Iım not convinced that this isnıt possible. Also, peopleıs sensitivities change in time. (This is why the question about new antihistamines). I think it may be worth more in the long run for CH people to diligently research and manage triggers.
So, thereıs an outsiderıs point of view from a strictly lay persons reference point.
I plan to pursue the allergist route and to discourage meds and give lots of positive support. He is not new to your ranks, itıs just that his situation (which Iıve known about only recently) has long passed the imperative point. When a malady affects your very life and the quality begins to be nil, something HAS to be done.
(By the way, in the last few days, with no meds, some avenues to pursue and more support, he has improved considerably...fewer attacks, theyıre shorter and less severe.) I think this sort of thing helps a body help itself.

Thanks Again, Doc G.

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