DATE OF POST: 9/3/2011 TIME OF POST: 7:43 am TOTAL HEADACHES TODAY: 1 TIME OF CH ATTACK ONSET: 4:30 am METHOD OF CH ATTACK ABORTION USED: Treadmill: warm up for 2 minutes setting 4, run for 3 minutes setting 6, bump to setting 6.5 and run for 7 minutes, cool-down run for 2 minutes at setting 3. Distance: 1.3 miles. Peak heart rate: 180. I also took a Sumatriptan (Imitrex) 100 mg tablet after, prophylactically.

NOTES Well that was ironic. I was just getting ready to sit down to blog about how well this cycle was going as compared to past headache cycle. Then I got that headache that took more than twice as long to kill on the treadmill than the others so far. And when I got out of the shower, I could feel that bastard starting to creep around already again, so I went ahead and took a Sumatriptan. That’s the first time that’s happened. I think this has to be attributed to the abrupt change in the Calan dosage. That’s my hope anyway (always hope). Hopefully that will be a one-off effect and the attacks will be easier to control again once my body adjusts to the lowered Calan dosage. The goal, obviously, is to eliminate both the headaches and the light-headedness. I suppose it remains to be seen whether both will be an option. If the headaches get out of control, I may need to go back to the Calan 240 mg and accept the light-headedness for a bit until the cycle is over. I mean it would suck, but I have to admit that I have gotten a lot of work done this week despite the impairment of that light-headedness. I would not have been able to function at that level with multi-hour cluster headaches.

On that note, I still have to say that overall this cycle has been much more controlled than any previous cluster headache cycle I’ve experienced. Apart from the first two attacks in the beginning which each lasted 1-2 hours a piece, the average length of my cluster headaches over the course of this cycle (since August 13; 22 days now) has been around 5 minutes or less. In previous years, the quickest I could hope to seize an attack was about 20 minutes using the Imitrex tablets. The Imitrex nasal spray was a bit quicker, but I recall that it didn’t always work and I often worried that I was not using it properly. What if I had a stuffy nose or something? Would it work then? Apparently not. And then there was the oxygen, which had initially promising results, but that also allowed the cluster to come right back shortly after the tank ran out. But in this cycle, I started fighting the attacks by running. And so far, every time, it has worked - far more quickly, and for the most part more effectively than the other abortive treatment options I have tried. And perhaps the best part of all: I can use this method as often as I am willing and have the energy for. There is no major risk of my blood vessels pinching shut in my brain; I don’t have to haul explosive tanks of oxygen around on the metro with me; and I don’t have to get a referral every 3 months for refills on this one. Running is all natural, and it works. The only question now is to what extent it’s working without assistance from the medications I’ve been on. To be honest, I’m getting a little suspicious now, given this morning’s episode. I was killing headaches very effectively for almost an entire week by running while just on the Prednisone and the original dosage of Calan (180 mg). Granted, I have been largely headache-free this last week. Significantly, I had no headaches overnight, so the only thing waking me up has been the need to pee (perhaps unrelated). Not sure if credit goes to the Topamax and/or Calan 240 mg for this, or has it been due to the prophylactic Imitrex before bed? Maybe a little of all of it. But what happened this morning? Could the extended attack have been avoided if I would have stayed on the Calan 180 mg and not had to make that adjustment? I think at the end of this cycle, the conclusion will be to take me off everything except the Calan 180 mg, since I have been on that for over 3 years now without any issues (or headaches until August 13). I have the blood pressure monitor in my headache bag now, so I can do a better job of keeping an eye on that pulse rate. If it continues to average in the 60’s after the cycle is over, maybe we can talk about reducing the dosage a bit. I got the pill cutter now, too.

VITALS

Time: 7:43 am
Blood Pressure: 130/78, 74
Temperature: 98.7
Weight: 202 
(Height): 6’3”
Age: 38

Called doc right after my lunchtime post and spoke to the assistant. Told her I’ve been dizzy since Saturday (day I started all the meds). She called the doc and called back with instructions to skip tonight’s Calan (Verapamil) 240 mg dosage, then tomorrow go back to the previous dosage of 180 mg. I was targeting the Topamax, but this seems just as reasonable. If the dizziness persists after a few days, I will call back. She also said drink more fluids. I was just talking about this issue today… After the call, I made the decision to head home early and rest. It’s dead anyway and I billed enough hours between Monday and Tuesday (while dizzy) to cover the rest of the week anyway. Pretty much.