Posted by Ueli (194.230.202.171) on December 07, 1999 at 08:20:37:
In Reply to: Imitrex rebound posted by Tom on December 06, 1999 at 19:37:35:
I think there are two kinds of CH attacks: Those that start spontaneously (albeit for many on a regular schedule) and those triggered 'externally', by alcohol, MSG or whatever you are sensitive to.
The first kind respond well to an abortive, like Imitrex, O2, etc. Although the second kind can be aborted as well, when the effect of the abortive wears out (in the case of Imitrex about 1 hour) the same trigger takes over again and the same attack resurfaces once more.
My experience from the old days, when I was 'treated' with Aspirin:
There were short attacks of 15-20 minutes with an extremely fast raise, from almost zero to peak in 2 minutes. After slowly going down to 80% of peak, the end of the attack was very abrupt: from 80% to 5% in less than half a minute. That was when the Aspirin kicked in, I believed.
The second kind of attacks lasted 1 to 2 hours. Pain level rose gradually over 15 to 30 minutes, and the tailing off was very slow, no abrupt end. Now I know that these attacks were triggered by a combination of beer and cheese or by MSG (I didn't know about triggers at that time) an the attack ended only when the triggering agent was degraded enough in my guts.And of course, Aspirin didn't help at all.
Now I'm taking Verapamil (560 mg/d) and my regular nightly attacks, 90 minutes after falling asleep, never raise above a Kip #3 and are easily aborted with O2 in 5-10 minutes. However, before I learned to avoid triggers, there were attacks in the evening that resurfaced again after half an hour and I had to repeat the O2 treatment 3 or 4 times. I am convinced that in this case the same attack showed up several times, and that there were neither new attacks nor rebounds.
After having annoyed my expert friends, I wish PFNAD's to all,
Ueli