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dental work triggers cluster?


mark m
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first things first I have always had clusters every three years, January 2019 was my last time so I should not have them again for three years from then. Recently I had a root canal upper right hand side which is the same side as my clusters. Now its infected and I am having cluster headaches because of it. Has anyone here experienced anything like this? The pain pills the dentist prescribed does not help I am on antibiotics too. But oxygen and imitrex do take the pain away. I was also put on emgality prior to the dental work. Anyone?

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Lidocaine, the anesthesia most commonly used has Epinephrine in it. That is the bug-a-boo. It will set off your head! It shrinks the blood vessels so he has less bleeding to cope with for your dentist

The best solution is to let your dentist know and request an anesthesia without it. Some buck up as the deadening effect is not as pronounced and a dentist can whig out over that. 

I am going to move this to the general board for the good of all Mark. :)  

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If you are having a series of attacks beyond the initial treatment it is likely the procedure has involved a nerve that is propagating the cluster sequence.  Its true the vasoconstrictive effect of epinephrine will tip the cluster cascade but the life of epinephrine is fairly short as are its constrictive effects so something else is engaged to have ongoing attacks.  I would go full beat down on this monster.  D3 with big loading doses, antihistamines (benadryl 25-75 mg every 6 hours, remember it can make you drowsy), bust if you must (or can), prednisone if you got it.  Attack without mercy and see if you can interrupt whatever triggered things.  You need the dentist so be sure to communicate with her or him.

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An infection means dead white blood cells. AKA pus. It causes pressure on surrounding nerves and blood vessels. As it goes away, some improvement should follow. They have not sealed it yet have they?

I too would hit it with everything in my arsenal. New activity should be squashed. 

My worst mess caused by Epi gave me ten hits in 24 hours post surgery to repair cut nerves and tendons in my thumb in 2018. The nerve block was supposed to last 12 hours at least. It was alive in an hour and I was still on my way home with no pain meds given on departure and script still over an hour away. The hits began about an hour after that and were severe. 

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On 2/16/2020 at 9:51 PM, sous139 said:

Hi Mark

Sorry to hear. I went in for surgery on the 6th, got knocked out, and cycle started on the 9th. I wonder if it is due to the anesthesia?

How has the Emgality worked?

 

If you require general anesthesia advise the anesthetist of your clusters.  Any decent anesthesia person should be aware of the condition.  Ask them if they think its ok to include ketamine and decadron to the anesthetic.  Propofol also can be helpful but ketamine is better (in theory at least)  Also request to wake up with high flow (10-15 lpm) running in the non rebreather mask.  These are rational reasonable requests and should help.  Frame the request as a question so it can be their idea ;-) 

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Yep. Talk to the doctor doing the anesthesia. I have now done that for three surgeries. They did not use Epi in the mix and I had my mask and 15lpm running and handed to me first thing. Once it was needed right then too!  They now have it in my record in two places and I like that.

They may make an odd face when you tell them to NOT give you any pain meds, just O2 please. ;) Not what they expect to hear at all.

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It appears they are slowly going away, I am having what I think is called shadow pains but no full on attacks now. Last night I was not woken up at all in pain. I am also on the last day of the antibiotics. I have not needed imitrex since Tuesday night. As for the emgality I have not had a migraine since the day after I took the emgality and my normal (for me) cluster register at a 10 + in painlevel but none reached beyond a 5 this time around also I normally have 4 or 5 per 24 hour period this time I never had more then 2. SO I may be a bit quick on the good for the emgality but so far so good. I still have slight constant pressure type pain daily but I have had thet for many years. My neurologist told me I should be the poster child for headaches. He is a great doctor for us with headaches of any kind. He even gave me his private email to send him things from research I find on headaches. Again thank you all very much for the help.  If there is a way to donate to the site please let me know.

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OK thank you Brain- at first it was due to an infection then it was caused by inflammation. I had the second appointment yesterday to finish the root canal and I am still feeling cluster type pain but I am going to take some aleve   prior to starting my day today to see if it helps.  I will donate next month, I seem to have missed one of my credit card payments last month so I have to catch up now. 

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  • 4 years later...

I’m a little late to this post, but I also had the same problem. I had a root canal started yesterday on the same side that I usually have cluster pain. As the anesthesia wore off, it was quickly replaced with cluster pain around a 7 or 8. I’m not in a cycle right now, and mine usually take weeks to ramp up when one starts, so this is out of the norm for me. 
 

Any guesses on whether it’s because of the root canal itself, or because of the epinephrine in the anesthesia? I have several more dental procedures on the non-cluster side of my face coming up, so I’m not sure how to handle those. 
 

Also, isn’t epinephrine sometimes used to treat cluster headaches?

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Yes, it's the epinephrine.  This is from the "Triggers" post in the CB Files section: "Anesthetics containing epinephrine (such as Xylocaine) and nitrous oxide have been identified by some people as triggers. Ask your dentist to use something else: Prilocaine seems not to cause bad effects. Another person has mentioned carbocaine as an anesthetic that didn't trigger his CH."

 

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On 10/2/2024 at 7:20 PM, CHfather said:

Anesthetics containing epinephrine (such as Xylocaine) and nitrous oxide have been identified by some people as triggers.

many moons ago when i was in the hospital for ch diagnosis, during an active cycle, the doc used nitrous oxide to trigger a hit. took less than 5 minutes for a full blown kip 8 attack. alas the test was positive...

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Thank you both so much!! I have a lot of dental work coming up so I’ll make sure it’s with the epi-free stuff. My dentist says it doesn’t numb as long or as well, but it should still be a better experience overall than the one I just had. 
Hopefully it just triggered a few unpleasant days rather than a whole cycle :rolleyes:

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20 minutes ago, snafu said:

many moons ago when i was in the hospital for ch diagnosis, during an active cycle, the doc used nitrous oxide to trigger a hit. took less than 5 minutes for a full blown kip 8 attack. alas the test was positive...

They gave you one on purpose??? That seems cruel & unusual :(

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6 hours ago, snafu said:

many moons ago when i was in the hospital for ch diagnosis, during an active cycle, the doc used nitrous oxide to trigger a hit

Are you sure it wasn't nitrogylcerin? That's what is usually used to deliberately trigger an attack.  

There have been people here who thought that nitrous oxide ("laughing gas") was a good abortive for them.

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  • 2 weeks later...

I have found that anything that disrupts my normal everyday life is a trigger. Interrupted sleep patterns is a huge trigger for me. For me the more I can keep things in the same pattern the better I can manage my attacks. 

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