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didgens

expecting heat wave this weekend

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I also wanted to add that he said something weird to me. He said I didn't catch it in time.  I said "what do you mean catch it in time?"  he said if I can feel it coming on and I sit up I can stop it or make it less severe.  ??? WTH ??

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didgens...

Yup, that afternoon nap (always on a day off) is a trigger, except it was the K7-8 that woke me up.  I could never wake it in time to abort with O2 quickly.

It is weird that occasionally the onset of CH is very slow.  I can stop it with cold water chugging or activity.  Especially with a difficult conscious exercise, like solving a problem or increasing mental liveliness with stress.  CH is so mysterious.

Heat wave in Calif?  Yessiree, it's coming.  10-15 deg F warmer than today.  Dry offshore flow too, and that means the allergies will be ramping up also.

Carry O2 in the car, no naps .... most of all wish him good luck!

weatherman  8-)

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Yes, catching it in time can make a big difference. If you feel the shadow start of it, you have a better chance of a fast abort.

My allergies are year round, so I don't find spring to be worse. My cycle is from the fall equinox to the spring equinox. Sort of. Mold and mildew are the culprits I suspect. But they are all respiratory allergies. So, I am not sure that they really affect my CH. Some day we will know the cause.

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Recently had a bad allergy attack less than 24hrs after busting. Seemed to totally defeat the bust and also increased the number of attacks I experienced.

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Always liked Accuweather's migraine headache maps.  What info do they use for that graphic ...... and is it really useful to migraine headache sufferers?

Lots of forecast goods for migraine people.  A favorite is the Migraine Monologues...

http://www.migrainemonologues.com/2012/10/a-migraine-weather-forecast.html

Phone Aps, Alerts and lots of other products to attempt prediction for these headaches.  If they work for you .... GREAT, but I doubt their practicality.

I'm still a big fan of the idea that there are primary and secondary triggers, and that usually more than one has to occur to provoke a headache.

weatherman  8-)

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An interesting and timely thread...  I may be able to contribute... You be the judge...

AlderCatkins_zpspotiycxi.jpg

PollenPickup_zpsgy6oj0zk.jpg

PickupHoodPollen_zps8t7xr6ps.jpg

My formerly black pickup mid March, a week into the Red Alder tree (Alnus rubra) pollen fall...  It's gotten worse since then.  The Red Alder pollen catkins are nearly spent, but the Bigleaf Maple (Acer macrophyllum) pollen drop is just starting... 

When I built the house in '82, I had a USDA Forest Service rep in to timber cruise the property.  He estimated the Bigleaf Maples growing near the creek were 200 to 220 years old with 34 inch diameter trunks at that time.  The Bigleaf Maple in the photo with sword ferns growing 20 feet up the moss covered bark has a 38 inch diameter trunk.  I measured its height with a laser range finder at 125 feet.

Bigleaf_Maple_zpss3nklesi.jpg

JurassicMaple_zpsf0upmelm.jpg

Bigleaf_Maple_Bloom_zps3cbfrjwe.jpg

The Bigleaf Maples are loaded with blooms... If last year was any indication... we've another two to three weeks of very high pollen count outside my bedroom window here in Kitsap County in the heart of Puget Sound, WA.

So what does all this forestry have to do with cluster headache...  A lot!!! 

I'm with Weatherman on primary and secondary triggers.  This concept makes good sense...  I've also been sharing data from the online survey of CH'ers taking vitamin D3 as part of the anti-inflammatory regimen to prevent their CH and some of my own observations with Dr. Todd Rozen, MD, Director Headache Program, Geisinger Health Care, Wilkes Barre, PA. 

I've been working with Dr. Rozen since 2007 when I introduced him to the demand valve method of oxygen therapy...  Dr. Rozen was also kind enough to swing by my poster presentation on the results of the survey of 127 CH'ers taking the anti-inflammatory regimen to prevent their CH at the AAN Annual Meeting in Philadelphia, PA last April.

ToddampPete_at_AAN_zpsa129a93f.jpg

I'm the old guy in the western getup on the right...  I didn't want any of the neurologists watching my poster presentation thinking I was a doctor...

I'm normally on a maintenance dose of 10,000 IU/day vitamin D3 with a 25(OH)D serum concentration around 80 ng/mL to stay pain free for most of the year...  However, for the last two years starting in March, I've titrated up to 25,000 IU/day and by the end of March I'm usually up to an average of 40,000 IU/day vitamin D3 in order to stay CH pain free. 

With the heavier than normal pollen this year, I've been averaging 50,000 IU/day vitamin D3 and doubling the magnesium to 800 mg/day since the first week in March...  Only it's not working as I'd hoped...

It's a little embarrassing to be the vitamin D3 guru and still get hit with CH... but that was the case three weeks ago...  I started getting hit up to 3 times a night while taking an average of 50,000 IU/day vitamin D3... Fortunately, oxygen therapy with hyperventilation knocked down these hits in 5 to 7 minutes.

At that point I went back over my notes and found the mechanism of action for an allergic reaction results in a flood of histamine... Pollen hits mast cells in the mucus membranes of the nasal passages, the mast cells dump histamines and other inflammatory agents into the surrounding tissues and blood stream and it's off to the races with an allergic cascade...

Another interesting part of an allergic reaction is there's a spike in the absolute eosinaphil count...  When the absolute count of these specialized white blood cells goes over 350, it's a good indication there's an allergic reaction present.

My PCP has been great following my use of vitamin D3 to prevent my CH, so I got him to write me a script for the CBC and WBC Differential blood tests...  I took the scripts over to the Naval hospital for a blood draw and two days later I got the results...  My absolute eosinaphil count was 390....

Another check of my notes along with some open source standard of care recommended treatments for allergies and up jumped good old benedryl, a first-generation antihistamine.  The rational for taking a first-generation anti-histamine is they pass through the blood brain barrier where second- and third-generation anti-histamines do not.  This allows benedryl to block histamine receptors in brain cells... and in turn, slow or stop the allergic reaction where it counts most for CH'ers. 

Accordingly, I started dosing with benedryl per the instructions on the bottle at 25 mg 4 times a day.  The results were dramatic...  In less than two days, the frequency and severity of my CH dropped to less than one mild hit a night (while sleeping), and these CH were so mild, they aborted very rapidly with two to three deep breaths of oxygen.  I've actually slept several nights totally pain free since starting the benedryl and I've also tapered my vitamin D3 intake down to 40,000 IU/day...

When I shared this information with Dr. Rozen, he commented I was spot on target...  He indicated they frequently treat migraineurs and a few CH'ers hospitalized due to their headaches, with a benedryl IV.

The thinking now is an allergic reaction impacts the vitamin D3 capacity to prevent CH by one or more of three mechanisms:  It totally overwhelms vitamin D3 genetic expression;  It interferes with vitamin D3 genetic expression; or the immune system response to the allergic reaction consumes available vitamin D3, it's metabolites and enzymes needed to hydoxylate vitamin D3 all the way to its hormonal form, 1,25(OH)2D3... leaving too little left to prevent CH...

Sorry, my degree was in chemistry... Hydroxylation is a chemical process that introduces a hydroxyl group (-OH) into an organic compound.  In the case of vitamin D3, two (-OH) groups are added, one each to the 1st and 25th positions on the vitamin D3 molecule to make 1,25(OH)2D3.

Connecting all the dots and piecing the puzzle together...  it appears an allergic reaction renders nearly all methods of CH intervention less effective at best... and totally ineffective the rest of the time...  That goes for imitrex,  oxygen, verapamil, vitamin D3, and psilocybin...

Moreover, it also appears that treating the allergic reaction with a first-generation antihistamine makes these methods of CH intervention affective again.

By the way, there are a number of studies that have concluded that mushrooms exposed to the UV-B in sunlight or UV lamps, results in a nutritional increase in the ergocalciferol (vitamin D2) content of mushrooms...  up to 990 IU/70 grams of fresh mushrooms...  If dried, the vitamin D2 content/gram is much higher...  See the following link:

http://omicsonline.org/a-nutritionally-meaningful-increase-in-vitamin-d-in-retail-mushrooms-is-attainable-by-exposure-to-sunlight-prior-to-consumption-2155-9600.1000236.php?aid=20611

Please understand I'm not suggesting this is the mechanism of action in using psilocybin to bust CH...  There's a very real mechanism of action involved in psilocybin's capacity to prevent CH...  The vitamin D2 content is none-the-less a thinker...   Your thoughts?

Take care,

V/R, Batch

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nice pic batch.  Have any of you ever had your doc do a blood serum allergy test when you have gone in for your regular annual blood work ?  I would suggest it.  I don't there is an extra charge its just another check box on the big sheet.  worth a look see

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