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Health Any kind of health issue, alternative medicines, herbal and folk remedies, etc.

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  #21  
Old 09-26-2015, 08:48 PM
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There's no advantage to seeing the doc when you're actually having a headache: there are presumably no physical signs for him to observe, except possibly the runny nose and tearing eyes, which you can easily tell him about.

Cluster headaches involve the eye & nose symptoms & signs. They are usually related to abnormal secretion of serotonin. Carcinoid syndrome needs to be considered- that often also includes episodes of diarrhea &/or asthma and flushing of the skin of the face & neck.

Then there's the colloquial use of the term "cluster headaches" when severe headaches occur in bunches over a short period of time. That's just a lot of headaches- either simple tension headaches or possibly true migraine (headaches caused by vascular spasm of the meninges).

Pts with very severe headaches often call them migraine even if they aren't really caused by vascular spasm. It makes a difference in treatment: all headaches can be treated with pain killers, tranquilizers, relaxation techniques &/or massage. Only migraines will respond to use of Oxygen or drugs like Maxalt or Immitrex or by pressure on a carotid artery.
I don't get teary eyes or runny nose during my clusters. If then it isn't any help to see a dr when they are active or not, then how will they know if it is a true cluster or just a migraine, or tension, or some other cause altogether? Just curious.
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  #22  
Old 09-27-2015, 10:03 AM
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Tension headaches and migraine typically are diagnosed based on history: the story the pt tells. Typically, a migraine has a prodrome- often a visual aura- that tips the pt she's about to get a headache. The headache itself is classically one sided and much more severe than "regular headaches" the pt has had before. There's usually a long history dating back to teen yrs and often runs in the family. An obvious trigger, like foods, time of the month etc supports the diagnosis and so can therapeutic trial: only migraine is helped by the Maxalt type drugs and rarely helped by aspirin type drugs. If these sever headaches are new, particularly in an adult over 25 or so, tests need to be done to rule out aneurysms, tumors and such.

Tension headaches often occur in the back of the head, are associated with times of physical or emotional stress. more likely to occur on rising (bad sleep position) or towards the end of the day (work problems) and often relieved by massage. Sinus headaches usually occur in the forehead and the pt has sinus problems (do ya think?).

The actual physical exam should be negative. A positive physical sign would suggest a more serious problem, like tumor (pretty rare). Blood pressure has to be very, very high before it causes headache-- more likely that tension/anxiety is causing both headache and elevated BP.

Except for the need to rule out more serious problems, the accurate differentiation between migraine, cluster & tension headaches is almost unimportant: it's the treatment we're worried about from the practical standpoint. While it's nice if the migraine responds to Maxalt, that's expensive and can only be used a couple times a week. I usually just prescribe hydrocodone-- it's safe, cheap and usually quite effective.
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Old 09-30-2015, 12:11 AM
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Great! Thanks so much, Doc.
I used to keep one on hand from when I was pregnant that I've asked my doctor about several times. Esgic-plus. Sound familiar? It worked great for treating my migraines when I was pregnant. It may have taken all day to wear it down until it went away, but at least it made it more and more tolerable with every dose. Would that be a good medicine for clusters?
Hydrocodone I'm positive helps most. It is cheaper and safer, I agree, and it generally makes all pains go away beacause you just don't care anymore about anything. LOL.
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  #24  
Old 09-30-2015, 01:18 PM
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. Esgic-plus.... Would that be a good medicine for clusters? .......
Hydrocodone .... it generally makes all pains go away beacause you just don't care anymore about anything. LOL.
The proof is in the pudding. Treatment is often a matter of trial and error. Whatever works for you is the right stuff.

Esgic is a barbiturate, while hydrocodone is a narcotic, and you're right-- they both work not by stopping the pain, but by dulling out your reaction to the pain. Far out, Man.
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Old 10-16-2015, 08:32 PM
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Great! Thanks so much, Doc.
I used to keep one on hand from when I was pregnant that I've asked my doctor about several times. Esgic-plus. Sound familiar? It worked great for treating my migraines when I was pregnant. It may have taken all day to wear it down until it went away, but at least it made it more and more tolerable with every dose. Would that be a good medicine for clusters?
Hydrocodone I'm positive helps most. It is cheaper and safer, I agree, and it generally makes all pains go away beacause you just don't care anymore about anything. LOL.
smittenkitten---just something i did when i had them---miserable mess---chase them with a cold pack then a hot pack---along with a prescribed med--I wont suggest anything--I had OTC med I took.

Just a thought--as I know how horrible these things hurt.
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  #26  
Old 02-10-2016, 11:05 PM
RochBear Male RochBear is offline
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Default Migraines

Hi,

A MD friend of mine and I were talking, and it turns out he's not only a Staff Dr. at Mayo Clinic, but also a head ache specialist. My wife suffers from migraines, and he told me about a "simple" fix. It's to inject Novocain into the muscles in the neck. This often gives immediate relief, but the important part is the relief often lasts for months - after the Novocain has worn off. That is the part the MDs admit, they don't understand why. But none the less, it's not very invasive, and relief can last for months. It would be worth talking to your MD about.

Some other things have been discussed above. B6 and B12 seem to help some people. Also female hormones seem to be a major triggering point for a lot of women. Sometimes hormone therapy helps, other's it makes things worse. Unfortunately, it is very individual.
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