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yes strenuous exercise is a major trigger for me. I am an amateur cyclist, I cycle about 4 to 5 days a week, distances between 30 and 80 miles a ride. The last 3 attacks I have had have all come from strenuous rides in the heat or being dehydrated due to running out of water. and then have put me in the 8 week cluster cycle. I have not had an attack for three years as I am on the D3 regime and became over confident and then rode very hard on a hilly course on aug 10th and bang, back again. Now in week 4 of the cycle, busting weekly with Vit M and last week with vitamin L, wake up nightly with the right eye pain and coffee aborts it, after the vitamin L , I have now had 2 nights of undisturbed sleep, hoping I am reaching the end of the cycle. I am also taking Quercetin, Tumeric, Vitamin C to battle histamine which also seems to have helped.

Mit, in my experience, shadows and hits post surgery are due to the Epinephrine in the anesthesia. I have had a major issue with that twice in the last 20 years. Both times, it lengthened my cycle and once I woke from surgery with a massive hit. You always insist on No Epi! They can use other anesthesia that does not contain any. They don't really like it, but I have found that all of my doctors will comply with that request. I always talk to the anesthesiologist if he is doing the anesthesia too! Your doctor can forget to tell them. So, when it is an outpatient surgery or worse, I have to tell them what I need post op if I have a hit: a Bottle of O2 with a Non re-breather mask at 15LPM. The two hospitals that I have done this with were both very helpful and compliant. When I woke with a hit, my nurse handed me the mask and did not try to make me lie down. It was perfect. You might need to do a 'dose' for it now to prevent the cycle that is threatening you.

Small Victory!! I got my mask!! Not from the doctors / insurance but from Clusterbusters.com <3 Came 100xs faster then then Apria delivered.