Posted by John L on December 02, 1998 at 14:33:07:
In Reply to: Re: Rebound Headaches posted by Jackie on December 01, 1998 at 18:41:54:
My episodes usually last for 3-4 weeks. The first two weeks suck, and then the third and fourth are no big deal. Here's my story. You'll see my medication is a work in progress.
In the spring of 1994 I woke up on a Sunday morning with the mother of all sinus headaches. I took (PANIC!) 6 red sudafed, 2 white sudafed (the equiv of four MORE red sudafeds plus antihistamine), 6-8 Advil and a couple of Vivarin (I somehow figured that might help -- lucky guess). Later that day I went to the doctor. He scolded me (rightfully so) for taking all those pills and prescribed a really strong decongestant. But a head xray showed no congestion. I got another headache either the next day of the day after. This time the doctor prescribed Midrin, on the theory that it was a migraine. It did nothing. The cycle of "get a prescription", "be confident that THIS time I've got the right one", "get another headache" was really wearing me down. After about three weeks I got the prescription for Fioricet. It worked great, although I've since learned that the last couple of weeks are all wimpy headaches. Then they stopped.
In the spring of 1995 I again started getting them. The Fioricet helped a little, but I needed to take six of them to make a dent, and I think it wasn't so much getting rid of the headache as knocking me out until it went away. After a week or so my doctor prescribed prednisone. I didn't get another CH after that. I though I had a cure, but again, it was late in the cycle.
In the spring of 1996 I got hit again. This time I went on the prednisone right away. My other follow up post details the rebound headaches I was getting. The headaches weren't supressed until the end of the prednisone like yours seem to be. When I'm in a cluster I can get rebound headaches, but the cluster lasts for two weeks regardless. After two weeks I seem to be able to shed milligrams pretty easily.
In the fall of 1996 I got them again, but this time I didn't get the rebound headaches, just the day of feeling lousy. Every day that I lowered my dosage was followed by a day of nausea and shadow headaches.
So this time (November 16) was the first time in two years. I went on the prednisone immediately and dropped from 60 to 50 mg after three days. Just after I went to bed on Thursday night I woke up with a nasty headache. It lasted for five hours and responded to nothing (actually, it responded badly to Fioricet3). I can tell the difference between the predinisone rebound headaches and the normal headaches because the rebounds are a tiny bit less severe, but they're longer and don't seem to be helped by anything. Normal ones last for 90 minutes and then I fall asleep. When I wake up I feel great! Rebounds last for at least three hours and they leave me feeling miserable all day, even after I wake up.
I also learned that during the first week a drop of only 5mg causes a headache. I thought this was strange, but if you need to drop in 1mg increments, I guess it's not so odd.
The only other interesting thing happened Saturday night. Saturday morning I took my prednisone on a mostly empty stomach. Saturday night I went to a wedding and had three drinks (I can have one drink with no problem this late in the cycle, but three might have been a stretch). At 2:00 on Sunday morning I got a rebound headache. It was very bad, but I've had worse. So my big question is was it a rebound headache caused by taking the prednisone on an empty stomach (less got absorbed?) or was it a result of drinking too much OR was it a combination of the two OR just a coincidence? Either way, I have no intention of sacrificing my body for science. I'm going to assume BOTH of those things are bad and not do them next time.
And now the cluster is over so I need to wait for a while before I can try again. Next time I'm going to try 60mg for seven days, 50mg for 7 days, and then drop by 10mg every 2-3 days until I'm done. The problem is that if I mess up, I get slammed with a headache, so there's a little bit of performance pressure on me.
Is it possible your CH pattern is changing? It's frightening to think that the one thing I've found that works might stop working some day. The other thing is that in the springs and autumns that I don't get the CHs, I get a cluster of shadow headaches for two or three weeks. It's like I'm getting a cluster but my body can keep it contained.
Gee. I had no intention of typing this much. But all my friends and family run away when they hear the word "cluster".
I sincerely hope your december episode is merely a fluke. They're bad enough to deal with when they're predictable and manageable.
Good Luck,
jpl