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Help! Travelling with Clusters

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I am currently going through a bout, not the worst ever, but a bout nonetheless. 

I'm leaving the US, headed to Mexico, in about a week and a half. It's not exactly something I can just scrap, change plans on, or not go. Tickets booked. You know. 

I mainly use oxygen and imitrex nasal spray or shots to deal if the O2 doesn't work (which it hasn't been this time around yay). I also take Verapamil and topamax on an increasing dosage as the headaches continue to try to get them to stop. Of course, it's not been going on that long yet, so I'm not that far along in the process, and it's not like they are looking like they are coming to an end anytime soon. Usually they go for about a month or month and half. 

So I have several questions for people. I don't know if anyone even knows. But I figured it was worth a shot. 

I personally know that prednisone will stop a bout for me (but only temporarily) and then when I start to taper they often come back with a vengeance. I seem to remember seeing somewhere something about a steroid shot? Is that a thing still? I'm asking because I have a doctor who is very open to trying stuff and reading up on the research and helping me out. 

Is it possible to get imitrex nasal or pens OTC in Mexico? Are they cheaper than in the US? I can't find anything about it specifically in my searches, but I do see that a lot of meds that are not OTC in the US are OTC in Mexico. 

I'm obviously not bringing a weeks worth of O2 with me on this trip. That would be utterly ridiculous. I use a tank per headache and am getting at least two a day right now. So the O2 is out. It's meds only. Does anyone have any advice for me that I haven't asked about or maybe thought of? I haven't ever flown while getting clusters. I've never travelled from one climate to another. Does it matter? Should I expect horrible things? (I kind of expect horrible things... i just want some inkling of what I'm getting myself into I guess). 


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At most Mexican resort destinations you can rent oxygen tanks. Ask you O2 provider what they will do for you (they should help you), and if necessary google [oxygen cancun] or something like that.  Bring your own regulator and mask, of course.

I have heard that the things you ask about are available OTC in Mexico.  Just walk into a farmacia and look around.  It's possible that Imitrex would be sold under a different brand name there.  If they have it, it will likely be much cheaper.  Consider stocking up!  (The usual warnings about reliability of medications in less-developed countries probably apply, but Mexico does regulate pharma, and if what you get is packaged from a reliable manufacturer, you could imagine it's going to be fine.)   At the worst, you could see a doctor for probably not much money and get a prescription.

I'm sure steroids can be administered in shots, but you probably want to do the taper, which as you know is pills that you could carry with you.  

Once you get through security, pick up a couple of 5-Hour Energy shots to use on the plane.  A lot of people get hit on planes, presumably because of the changes in cabib pressure.

I have been surprised by how many people ask for vacation advice and for some reason find that their attacks are less bad when they are traveling than they are at home.  I'm hoping you might be another of those.


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I can confirm the tendency of latin countries having a lot more meds available OTC then the so called 'first world countries'. I guess because of lack of doctors in remote areas, it would/is more important to get certain medicaments which normally are unter strict control of a doctor in order to prevent disasters in the first moment until people can get a grip on a doctor which sometimes can be a big hassle or even serious problem.

As an example in brazil I can buy Naratriptan (Naramig) and Sumatriptan where the first is cheap(around 2usd per pill) the Sumatriptan(85mg&500mgNaproxen anti-inflammatory) 2 pills at around 12usd. Sumax-Nasal/Sumatriptan for 2 shots at max 15usd.

Also as CHfather mentioned people find that their attacks are less bad when traveling sound OK to me even not having had the same results I really can unterstand this as an effect changing environment drastically. What I'm asking myself is if this effect least for a time or just for a short period.

One thing I like to mention is the hyperventilating technique using a simple paper bag. You may have a closer eye on this one as it could be used in... yes during flight.


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It is mushroom season in coastal Mexico.

You can get good quality medication OTC or other in Mexico. Most large pharmacies hire a doctor on staff to write prescriptions and the fees for that are nominal.

My recommendation would be to drink TONS of water during your travels, and to keep your prednisone handy. Avoid all alcohol. 

Have fun!

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You should have no issue taking your nasal spray with you in your carry on I don't think. I would check with the airline before heading out though. If not, take your script with you.

Many will take some energy shots in their carry on bag too, just in case.

As urs said, hyperventilating can be a big help in slowing or stopping a hit at times. I would not use the bag though, as you want more O2 not the CO2 you exhaled. Just breath in deep and exhale with force. Repeat. It helps clear the CO2 out. If others are around, then do a long exhale instead of faster and with force. But inhale quickly and hold it for a few seconds.

As for the Pred - I would start it the day before my flight. Then have a new taper pack for the return trip. Assuming that you will be there over a week of course. You normally would not want to take to taper packs back to back. But this might be a special case scenario. Not like you are going to be taking the stuff daily for your entire cycle.

Sorry, that is all that I can think of at the moment.

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