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Everything posted by BostonHeadacheDoc

  1. BostonHeadacheDoc


    Hi Folks, I did bring up Ketamine at the Las Vegas conference. Would have liked a more substantive discussion however, but there were time issues! As some of you know, I do prescribe it on occasion. It is certainly no worse that using opioids and likely better! Yes one must be careful, like with many many things. It will always be a challenge to get it from someone who has NEVER prescribed it before. The US is lucky that it is only a schedule 3 agent, while in Canada it is schedule 1, non starter! As with other medications, take enough and you are 'out of your tree' (like with Benadryl, alcohol etc) but I generally trust patients to be cautious and give them the benefit of the doubt. I have found that the compounding pharmacies have been helpful and do not look upon me as a dope peddler! Remember the compounding pharmacies are our friend. It has yet to be determined what long term treatment concerns there would be with ketamine. I suspect it is best used with breaks so the body can loose the tolerance to it. Desperate situations deserve brave choices and that is how I ended up writing some patients for this. Have to admit as yet no disasters and nobody hated it. All some degree of positive. As yet we still do not know the ideal role it should play. FYI Very soon, the academic journal HEADACHE will publish a 5,500 word review of mine that covers cannabinoids (not useful here) and hallucinogens for headache. I do mention ketamine positively so that would be something to show a skeptical physician (yes psilocybin mushrooms are covered in a positive way as well). Cheers, BostonHeadacheDoc
  2. BostonHeadacheDoc

    New user with similar headaches to Cluster (SUNCT)

    Welcome RSoxGuy, You really should think about coming to the meeting in Las Vegas this Friday/Sat Sept 21 & 22nd. Last year a patient of mine with SUNCT actually went. I have insider info that the sign up is very high already so plenty of opportunity to meet other folks. BHD
  3. BostonHeadacheDoc

    My doctors visit

    toostrike, my sympathies. Any reasonable physician should not deny you an oxygen script. I do not understand that at all. Maybe you can find an interested Nurse Practitioner who may be more likely to look up cluster headache rather than shoot from the hip. You need to tell any future prospective primary care MD very early on that you have cluster headache and will need a prescription for oxygen and would that present a problem. Ideally you need a neurologist (American Headache Society can help you with that) but looks like your situation at the moment will not allow that. Regards, BostonHeadacheDoc
  4. BostonHeadacheDoc

    best neuro i have found!!!!! in florida

    I happen to know Francis X Conidi, MD from his time in Boston, and also am aware of his good friend who does indeed have cluster headache! Small world, BHD
  5. BostonHeadacheDoc


    Hello Alex, By floaters I presume you mean the visual symptom of somthing small/tiny floating in your vision- often like a small speck. Overwhelmingly, these are natural- from slow degeneration of the vitreus (jelly in the eye) and can be more common in some folks, especially associated with certain retinal problems. To my knowledge they are not associated with those medications. Topiramate can have visual side effects but there are much more profound. Hope that helps.
  6. BostonHeadacheDoc

    Anyone's doctor on board about busting?

    Well, well, it is going to be an interesting meeting! I do really want to learn about what you folks do and hopefully will hear some stories etc. Frustration and anger I feel should be directed against the NIH and politicos who will not invest a dime in this disorder (our tax money); and, directed to increase awareness amoung health providers. In Feb 2009 I did go to Washinton and lobbied for more headache research- into the offices of my 2 senators (Kerry and Kennedy) and 6 congressional offices. Incidentally I do see some CH sufferers who respond to medications well- likely are not here! I am a bit sensitive to open Pharma bashing as at least they are helping some people.
  7. BostonHeadacheDoc

    Anyone's doctor on board about busting?

    Thanks for the comments folks. To Johnny who wrote 'just curious but do you think doctors would recommend this treatment if they didn't get kick back from pharmaceutical companies?'. I think you are serious and that is troubling. Physicans not recommending this has everything to do with poor knowledge, legal concerns and the conservative nature; nothing to do with Pharma. . Without Pharma patients would be way worse off.
  8. BostonHeadacheDoc

    Anyone's doctor on board about busting?

    Interesting question. I am a physician doing a lot of Headache Medicine in Boston. It is my understanding that we do have first amendment-free speech protections when mentioning this treatment- and I do. I have informally discussed this with an attorney. Amazing how closed minded some physicians are! I am going to the Portland meeting, the first Clusterbusters meeting for me and looking forward to it!