Sumatripton help

[johncluster]

9 hours ago, Into Light said:

I just ordered the 0-25 Lpm for M tanks from the provided link.

hopefully, this will do the trick. At $54, it’s worth a try.

 

jonathan

you dont have to keep it at 25LPM at all times,,,,you dont wanna waste your oxygen,,,I start at 25 then as the pain is disappearing and I start to breath slowly I turn it down to 15,,,and then 10

[Into Light]

Thank you.I am just excited to have found, through a link someone to buy my own regulator.. I will definitely try that.

[Into Light]

7 hours ago, Pebblesthecorgi said:

 Just for the record studies done looking at aborting clusters earning Class A evidence for efficacy were all done at flow rates of 6-12 LPM.  If these flow rates are not effective for an individual then trying higher rates (masks and technique too) is certainly acceptable but if you doc and O2 provider start you with a regulator that can only do 10 LPM don't despair the chances it will work are pretty good.

Thank you. I have read some of the journal articles. For me, the 15 Lpm gave me about 1/3 of an in-breath before maxing out. I will try the reduction in flow over time.

[Into Light]

Boatman,

I don’t know how else to describe the experience when I am not in the spring and fall intense ch attacks. I have ongoing 1-2 level pain the rest of the year;  they are often accompanied by the ancillary symptoms of running nose and tearing/drooping eye. All right side. They, as mild as they seem leave me mentally incapacitated even if they stop for a while.. so that’s what I call mild chronic CH with episodic attacks much more painful..

Right now, my pain level is barely a 1, but my right nostril is running.

i hope that clarifies. I was wondering if anybody ellse has experienced this.

[Pebblesthecorgi]

May be true for you but if you look at the studies providing the evidence for giving O2 therapy evidence of efficacy the flow rates used were 6-12 lpm.  There are many variables in the equation so some people will need higher flow rates and volumes but the majority will not.

[johncluster]

21 minutes ago, Pebblesthecorgi said:

May be true for you but if you look at the studies providing the evidence for giving O2 therapy evidence of efficacy the flow rates used were 6-12 lpm.  There are many variables in the equation so some people will need higher flow rates and volumes but the majority will not.

I am not sure if you have a non -rebreathable mask at home 3L bag that most ppl use. 

Set your flow to 6-10 LPM  and start breathing and you will have to remove it from your face after 3-5 breath ,  bc you will run out of O2 from your bag.

At 6LPM my bag was empty after 1 breath. 

The study must be including a face mask which mixes air with 02.

It is technically impossible to breathy at 6LMP  . You 'll run out of air. with the masks most ppl here use.

 

Edited April 5, 2019 by johncluster

[Pebblesthecorgi]

10 hours ago, johncluster said:

I am not sure if you have a non -rebreathable mask at home 3L bag that most ppl use. 

Set your flow to 6-10 LPM  and start breathing and you will have to remove it from your face after 3-5 breath ,  bc you will run out of O2 from your bag.

At 6LPM my bag was empty after 1 breath. 

The study must be including a face mask which mixes air with 02.

It is technically impossible to breathy at 6LMP  . You 'll run out of air. with the masks most ppl here use.

 

The average tidal volume of a male is 500 ml.  So if you have a 3 Liter bag that would have 6  tidal volumes, even if you have twice the average tidal volume a 3 liter bag would have 3 breaths without refilling.  Normal respiratory rates are 12-20 breaths per minute.  So if you are breathing at say 15 breaths per minute with a normal 500 ml tidal volume you would use 7500 ml of oxygen per minute.  So If you start with full 3 liter reservoir bag and a valve flowing a 6 LPM the bag is capable of being filled every 30 seconds you should not run into an empty bag until near the end of a minute assuming a person could maintain that pace.  Running at 10 LPM starting with a full 3 liter bag would be difficult empty the bag.  Now of course respiratory rate, lung capacity and length of expiration will play a role.  Each individuals physiology and anatomy will influence what flow rates work but for the majority of folks the valves provided usinf a rebreather or optimask set up should work.  I just don't want folks to become discouraged if they get a 6-12 lpm valve and not try it.  Breathing technique is probably more important than flow rates as blowing off CO2 likely produces the effect we want more than having the O2 running through our arteries.

[CHfather]

2 hours ago, Pebblesthecorgi said:

I just don't want folks to become discouraged if they get a 6-12 lpm valve and not try it.

I agree that this is very important, and appreciate your making this point.  My anecdotal observation suggests that particularly for people using O2 for the first time, "lower" flow rates often work out okay.  

14 hours ago, Pebblesthecorgi said:

if you look at the studies providing the evidence for giving O2 therapy evidence of efficacy the flow rates used were 6-12 lpm.

I don't know about 6-12 lpm, but the major study by Goadsby et al (double-blind, placebo, etc.) used only 12 lpm.  And the results of that were important and good, but "only" 78% of the participants were pain-free after 15 minutes.  I might have severe confirmation bias, but I think that's a lower percentage than we see with higher flows.  There's nothing in that study about speed to abort below 15 min, so we don't know whether higher flow rates are faster, but again my possibly bias-infected observations say they are.  Is there some kind of cart-and-horse thing here, where higher flow rates don't just support the more effective breathing that you suggest but actually induce it?  No idea, and as you say, if the bag is full when you're ready to inhale using effective breathing techniques, then you have a proper flow rate.

2 hours ago, Pebblesthecorgi said:

blowing off CO2 likely produces the effect we want more than having the O2 running through our arteries

Is this related to the general presumption (in the absence of a definitive explanation for the effectiveness of O2) that O2 works by dilating blood vessels? Or is "dilating blood vessels" just some kind of conventional wisdom that is widely stated without any foundation?  Does expelling CO2 dilate blood vessels, or are you suggesting that it affects CH in another way?  Why the heck can't it be figured out why O2 works?  Why did Kudrow think it would work?  These are just curiosities I have -- I'm not challenging you at all, just wondering.

Edited April 5, 2019 by CHfather

[Pebblesthecorgi]

I think the general idea is that hyperventilating reduces CO2 levels which creates an imbalance between CO2 levels and O2 levels which results in respiratory alkalosis.  The respiratory alkalosis results is cerebral vasoconstriction which contributes to the desired effect of pain relief.  The high O2 levels independently promote central vasoconstriction through a mechanism that is unclear.  Our Boston neuro friend had a slide with the putative mechanism of action for O2 but in the end we don't know for sure why.  My guess Kudrow was trying things to change Ph or observed a patient who was coincidentally getting O2 .