triggers vs inensifiers, cluster vs attack

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Posted by gary g ( on December 14, 1999 at 12:10:03:

good discussion lately re: triggers etc

to communicate well about CH, with DRs, each other, insurers, etc it is important to have at least a little specficity;
from several posts, it seems some clarification would help everybody:
there really isn't an "official glossary" on this stuff, but I sense the following to be pretty conventional:

CLUSTER: in CH we have lengthy periods of time during which our "system" is somehow off balance, and during which we are subject to various symptoms; these time periods are very definite entities in themself, the Cluster; a cluster is continuous 24X7;
it is completely possible to go into a cluster and NOT have any attacks - rarely naturally, but more usually through effective attack suppression treatment

ATTACK: while we are in a Cluster, one of the symptoms is a short (15 minutes to 2 hours, usually)episode of extreme pain in one orbital/templar region (trigeminal nerve served area); this Attack occurs frequently, often several times a day, during the Cluster period; it does not ever occur if we are not in a cluster;

(Think of thunderstorm - the black sky, high winds,rain are the Cluster, the individual lightning strikes are the Attacks;
even the way they occur is parallel - Tstorms & clusters both build up fairly slowly, stay steady for a sustained period of disturbance, then tend to end VERY quickly and definitely)

TRIGGER: some ingested, environmental or activity related agent, that starts a cluster OR provokes an attack during a cluster - is most accurate if we say "attack trigger" or "cluster trigger"; a Trigger is a starting point event - it doesn't affect how long or severe the cluster or attack will be

INTENSIFIER: some agent which makes a preexisting or predictable future attack/cluster worse
an Attack Intensifier makes an attack worse;
(more severe, longer or both) - this is what is often confused with a Trigger;
a few substances/events/environments can be BOTH a trigger and an intensifier;
a Cluster Intensifier makes the overall cluster longer and/or causes more attacks per day;

hope this helps folks who haven't got this thing sorted out yet

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