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BostonHeadacheDoc last won the day on May 8 2019

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About BostonHeadacheDoc

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  1. Hi bobcat, Well that sounds rotten. Certainly not CH as the headache is all day, also CH is strictly one sided- sounds like yours is not? Not CH in which case verapamil is not going to help at all at all. Indomethacin is non specific, certainly a good anti-inflammatory, beware known to be very irritating to the stomach. Best avoid using the term cluster-migraine as it causes mass confusion and it is mostly used by folks who know not what the attacks are. Your story at the gym (at least you were lifting a dumbbell) and sudden headache- that is often one of 2 things, a thunderclap he
  2. I sent a PM to Concerned mom and offering all help I can, happy to see this young man soon.
  3. Hi Dan, Well you have the correct goal. Generally with cluster headache if you are not sure that a treatment is working- then it is NOT working. You are on a high dose of topiramate- did it ever work? How did you get up so high? If it is not helpful at 200mg a day then will not be at 600mg a day. Lucky for you tapering is easier with CH than with migraine. Suggest come down by 25mg-50mg a week. Not an exact science and you can cut the pills. Ideally with physician involvement we write scripts for 25mg tabs which makes tapering to zero easier. As you go lower you can take it all at night.
  4. Matakarap, FOCUS. LISTEN- O2- at least 15liters/min via face mask, do it to abort. sumatriptan injections any dose- nasal spray not good in comparison- zolmitriptan is better if you really want to use nasal spray! STEROIDS. Calm down these are anti- inflammatory steroids and often stop the CH, albeit temporarily in many people. Take in the morning. VERAPAMIL Yes a minority of clusterheads actually have benefit so you deserve it to yourself to try the instant release form (80mg 3 times daily going to 2X80mg 3 times a day Peace, BostonHeadacheDoc!
  5. Dear Kristofer, Sorry to hear of your trouble. Some advice- if it is at all possible you should attend the Clusterbusters Annual meeting Sept in Denver. You will find out there are people who have had chronic CH for longer and all sorts of advice from many who have found success from an even worse position (like Bob Wold!). Seriously you need to be there. You need to talk to other chronic CH folks,- how many have you met? Opioids have no role in cluster headache. Before you construct a rebuttal to that, just think, how bad you are, on opioids and ask yourself, are they working??? You
  6. I contacted the company that makes the gammaCore device. I am satisfied that the signal is an electrical one, and not just a sound. spinebob I am happy to continue this conversation as needed, you may have more information. I appreciate your skepticism, but in this case it does not appear to be true. I am not an engineer! Regards, Brian E McGeeney, MD, MPH, MBA BostonHeadacheDoc
  7. Hi blueblueblue, So how is the migraine coming along? - only kidding! Sorry to hear of your troubles and welcome to the group. There is an extremely active closed discussion group on a certain other social media platform that you will be told about, featuring many of the Clusterbusters group members. You need to attend the annual Clusterbusters meeting in Denver, middle of Sept 2018. I am happy to facilitate an early office visit on your request-if you are interested message me with your contact info, I have not been on here in a while but will keep an eye out now. Regards,
  8. Too funny Prof! I am going to take it!!! BostonHeadacheDoc ;D
  9. Dear kmom, There are useful suggestions in this thread from very knowledgeable people. I do not think I saw steroids mentioned. The quickest way out of a cluster period (although it may be temporary) is a course of oral steroids like prednisone. The same thing you would get for an asthma attack or hives. Mostly they are well tolerated and safe, for short courses. Many on the board have used this medication. Mostly, people do well. His student health services could even prescribe this. Please keep us updated, Regards, BostonHeadacheDoc
  10. Dear didgens, The more we know in medicine, the more we know what we do not know. We only understand a minority of disorders to the full extent, and many hardly at all. The complexity of biology at cellular/genetic level is the problem. Even if we do not understand the root cause of most disease, at least it can be defined and classified. Putting a name to something is of benefit to patients and that allows us to treat, often with some clinical trial backing, as we could define a disorder, which enables one to study better. What really bothers patients is actually the lack of good treat
  11. Dear kmom, Sorry to hear of your trouble. Could you please state where in the world he is- I presume, but do not know, that he is in the US. If so which state/town/city. It is important that a correct diagnosis has been made, even before venturing into treatment. Was he diagnosed by a physician? by a neurologist? With respect, BostonHeadacheDoc
  12. Looking forward to the conference! Sorry that I will not see some folks who cannot make it, but sounds like it will be a big meeting. All going to plan will be at the reception on Thursday evening 8-) BostonHeadacheDoc
  13. Hi brs82, DHE 45 is dihydroergotamine, hence it is an ergotamine, but one with poor oral absorption. So it is given in other routes- as a nasal spray, under the skin (subcutaneous injection) or intravenously. There is even an inhalation product in late development. On occasion I admit patients to hospital for DHE intravenously every 8 hours for a few days- works in most people but often the attacks of cluster come back after the therapy. Can give patients a much needed break, emotionally useful, even if the break is only temporary. I also prescribe DHE vials, then come in packs of 10, an
  14. Interesting thread! Patients with migraine tell me that indica is better. We in MA have yet to open up the marijuana dispensaries, so I do not have as much experience directly with the individual marijuana types. Orally consuming cannabinoids before bed is interesting, and likely would avoid the triggering factor of smoke when dealing with cluster headache. Would certainly be worth a try. Prior to the 1930's oral tinctures were the main route of admin for cannabinoid medications. More I think about it, really good idea- you would quickly find out if it prevents bedtime attacks. CBD may no
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