DATE OF POST:  9/3/2011
TIME OF POST:  8:40 pm
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

Not much to report since this morning.  I’ve felt some tightness in my head most of the day today, but I didn’t have a second headache.  I regret not getting a chance to ride my motorcycle today, but the dizziness was still too much.  Hopefully that will be gone tomorrow and I can get a ride in.  Also didn’t work out today as I had planned, since I started the day with a long run to kill that headache.  I’m going to try to get in a workout tomorrow.

VITALS

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

SIDE EFFECTS EXPERIENCED TODAY

• Light-headedness
• Light pressure throughout my head most of the day; tightness around temples and eyes

ACTIVITIES

• Cut the grass; pulled weeds (am)
• Groceries
• 14 minute run (headache abortive)

MEDICATIONS

• See updated schedule
• Morning dosage taken at 8 am
• Evening dosage taken at 8 pm

MEALS

• Breakfast: vegetable and cheese omelet (broccoli, mushrooms, scallions, mozzarella, asiago, olive oil, three eggs; flat bread and hummus
• Lunch: Zoe’s: grilled chicken pita; Greek salad
• Snack: carrots, celery, red bell peppers and hummus
• Dinner: sausage barley soup with spinach; asiago garlic bread

FLUIDS

• Coffee: 8 oz
• Unsweetened iced tea: 32 oz
• Ginger ale: 12 oz
• Water:  48 oz

WEATHER

• 73-83, partly cloudy

WORKOUTS

• Headache abortive run only

STATS

POST WORK OUT VITALS

WORKOUT NOTES

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

DATE OF POST: 9/2/2011
TIME OF POST: 11:09 PM
TOTAL HEADACHES TODAY: 0
TIME OF CH ATTACK ONSET: N/A
METHOD OF CH ATTACK ABORTION USED: N/A

NOTES

Between the stressful work week and the dizziness, I have not had motivation or energy to work out this week. I plan to work out tomorrow. On a positive note, my headaches have been minimal this week. Although the side effects have presented challenges, the meds seem to be working. Just need to find the right balance. Working on it.

Doctor returned my call today. We discussed the side effects I’ve been experiencing this week. We discussed my blood pressure (which has been normal, although my pulse has been low). She said she believes the Calan is causing the side effects, pointing to the low pulse. I recalled that we previously had me on Inderol, another blood pressure medication, and that caused similar side effects. The Calan 180 mg was the option she put me on from the Inderol back then, and I stayed on that for 3 years without issue. Therefore, she put me back to that dosage today. She said she wants to keep me on Topamax at the current dosage. Previously, she put me on Topamax just before the Cluster Headache cycle stopped, and I stayed on it for a few weeks. It was late in the cycle at that point, so it was hard to say whether it was the Topamax that anded the headaches. That’s what we are trying to find out now. In any event, as far as the side effects go, I believe that if I were having these side effects with the Topamax previously, I would have been taken off the medication and she wouldn’t be giving it to me again now.

VITALS

-Time: 11:57 am
-Blood Pressure: 131/89, 68
-Temperature:
-Weight:
-(Height): 6’3”
-Age: 38

SIDE EFFECTS EXPERIENCED TODAY

-Slight vertigo (head slightly spinning, kind of vibrating, but no nausea). Was less than yesterday. Started to build up around 11 am, peaked around noon, then gradually came down over the rest of the day. Had the feeling all day.
-Cold, tingling lips

ACTIVITIES

-Went to work

MEDICATIONS

-See Medication schedule: http://clusterheadachewarrior.tumblr.com/post/9464792685/saturday-august-27-2011-updated-meds-schedule
-Meds taken at 8 am and 8 pm
-Added Naratriptan (Amerge) 2.5 mg to 7:30 am meds
-Added Sumatriptan (Imitrex) 100 mg to 8 pm meds
-Modified Calan prescription dosage from 240 mg to 180 mg because of side effects
-Modified Topamax schedule: to stay at current dosage through cycle rather than increase by half a pill
-Will stop using Naratriptan prophylactically in morning

MEALS

-Breakfast: 2 lunch meat turkey, egg, 2% skim American cheese sandwiches on whole wheat English muffins
-Snack: small grits with one packet of salt
-Lunch: 1 slice vege pizza, 1 slice pepperoni pizza, small mushroom bisque, handful of Cheezits
-Dinner: small bowl of chili, tortilla, small plate of tuna noodle casserole, hummus and flat bread, salad

FLUIDS:

-Coffee: 12 oz
-Cranberry Juice: 4 oz
-Water: 78 oz
-Ginger ale: 12 oz
-Club Soda: 12 oz.

WEATHER

WORKOUTS:

-None today

STATS:

-N/A

POST WORK OUT VITALS:

-N/A

WORKOUT NOTES:

-N/A

Total Headaches Today: 0
Time of CH attack onset: N/A
Method of Abortion: N/A

Notes

I’m submitting this post as I eat my lunch. Probably shouldn’t be eating this “rustic” potato soup, which will likely leave me bloated for the rest of the day. Whatever, it’s delicious.

Quiet day at work again today, thankfully. I had a lot to do when I got in at 6:30 this morning, but after 7:30 things got quiet and I have been able to work at casual pace.

I had no headaches last night or this morning. I woke up several times to pee. On that note, I’m going to cut back on my caffeine. I’ve been getting out of hand with it. 2-3 cups of coffee (which I usually only drink halfway, dump, then refill, so really 2 cups average) in the morning, sometimes I will have another cup of coffee in the afternoon, and then 1-2 glasses of unsweetened iced tea with dinner. I need something else to drink. I mean obviously water would be ideal, but I am already drinking several glasses of water throughout the day on top of the other fluids. At this point I feel like it would be a mistake to go back to regularly drinking the Crystal Light Lemonade, which contains Aspartame (a known associate of Cluster Headaches). There’s regular Lemonade, but I don’t want all that sugar. Alcohol is out while I’m in cycle and on meds, and not something I want to drink every night anyway. Milk is only good with spaghetti. I guess I’m back to the club soda. That actually works. I need another case though - the one at home seems to be flat for some reason. Maybe it’s just my numb head screwing with my sense of carbonation.

Which brings me to these side effects. All day with the numb, vibrating, vertigo head. I’m on so many drugs now that I don’t know which may be causing this, and it sucks. But, hey, only 1-2 headaches a day tops, and I seem to be blocking them altogether some days. Considering what this experience has been in the past when I was getting hammered by 1-4 hour demonic eye drillings 3-4 times a day, I should probably be fully embracing this silly goofy light-headedness. And it doesn’t even cost me that much anymore.

I disagree. I demand normalcy. I didn’t do anything to deserve these headaches, and it pisses me off that the best alternative I seem to have at present is quasi-intoxication. Bullshit. I’m calling the doctor and coming off something.

I have killed every attack from simply running for 5 minutes. If reducing or eliminating the meds means I risk getting more frequent headaches but I get a clear head, then so be it. I will just have to bring my running shoes to work with me and be ready to head down to the gym.

Vitals

• Time: 5:00 pm
• Blood Pressure: 132/77, pulse 60
• Temperature: 98.4 
• Weight: 204
• (Height): 6’3”
• Age: 38

Side Effects Experienced Today

• Slight vertigo (head slightly spinning, kind of vibrating, but no nausea)

Activities

• Went to work
• Left work early
• Relaxed at home

Medications

• See Medication schedule: http://clusterheadachewarrior.tumblr.com/post/9464792685/saturday-august-27-2011-updated-meds-schedule
• Meds taken at 7:30 am
• Added Naratriptan (Amerge) 2.5 mg to 7:30 am meds
• Will add Sumatriptan (Imitrex) 100 mg to 8 pm meds

Meals

• Breakfast: 2 lunch meat turkey, egg, 2% skim cheddar cheese sandwiches on whole wheat English muffins; 1 cup coffee; 1 small cranberry juice
• Snack: 2 egg and cheese muffins; coffee; water
• Lunch: Turkey and Swiss wrap with mustard; small “rustic” potato soup
• Snack: Chicken and rice soup, ginger ale
• Dinner: Margarita chicken, black beans, hummus and flat bread, ginger ale

Weather

• 77, hazy

Workouts:

• None today

Stats:

• N/A

Post work out vitals:

• N/A

Workout Notes:

Total Headaches Today:   0
Time of CH attack onset:   N/A
Method of Abortion:  N/A

Notes

Mercifully quiet workday.  Tired from the last few days; shin-splints from the Cole Haan office jumping jacks to abort yesterday morning’s CH attack.  Took a Naratriptan (Amerge) with the 8 am scheduled meds as a prophylactic in anticipation of another 10 am CH attack.  Appears to have been successful as I had no headaches today.  Left work at normal time today.  Otherwise, uneventful.  Planning to get to bed by 9 tonight.  Just took Sumatriptan (Imitrex) with the 8 pm scheduled meds as a prophylactic. 
 

Vitals

• Time: 8:13 pm
• Blood Pressure: 126/65, pulse 64 
• Weight: 206 
• (Height): 6’3”
• Age: 38

Side Effects Experienced Today

•  Slight vertigo (head slightly spinning, kind of vibrating, but no nausea)

Activities

• Went to work

Medications

• See Medication schedule: http://clusterheadachewarrior.tumblr.com/post/9464792685/saturday-august-27-2011-updated-meds-schedule
• Meds taken at 8 am and 8 pm
• Added Naratriptan (Amerge) 2.5 mg to 8 am meds
• Added Sumatriptan (Imitrex) 100 mg to 8 pm meds

Meals

• Breakfast: 2 lunchmeat ham, egg, 2% skim mozzarella cheese sandwiches on whole wheat English muffins; 1 cup coffee; 1 small cranberry juice
• Snack: 2 egg, vegetable, cheese quesadillas; coffee; water
• Lunch: Greek salad with grilled chicken; hummus and pita; water
• Dinner: tuna noodle casserole; salad; unsweetened iced tea

Weather

• Sunny, 75

Workouts:

• None today

Stats:

•  N/A

Post work out vitals:

•  N/A

Workout Notes:

Total Headaches Today: 1 
Time of CH attack onset: 3:30 am
Method of CH Abortion: Treadmill, setting 6, 5.5 minutes

Notes

Work was stressful and ran late today.

I went with the Sumatriptan prophylactic last night with the 8 pm dosage rather than the Naratriptan.  The results were as I predicted: CH attacks prevented through the first two attack windows (8-10 pm; 12:30-2 am), but I woke up to the beginning of an attack at 3:30 am.  I aborted the attack on the treadmill at setting 6 for a 5 minute run.  Honestly, I killed it before it ever got painful enough to feel like it was going to amount to a full Cluster Headache, so I’m not really sure if that’s what it was.  The signs were there though, so I’m treating it as an attack.  

Other note:  You can now follow this blog on Twitter: @CH_Warrior

Vitals

• Blood Pressure: 114/68, pulse 47 (8:05 am)
• Weight:
• (Height): 6’3”
• Age: 38

Side Effects Experienced Today

Activities

Medications
(see updated schedule: http://clusterheadachewarrior.tumblr.com/post/9464792685/saturday-august-27-2011-updated-meds-schedule)

• AM Dosages taken at 8 am

Meals

• Breakfast: 2 lunchmeat ham, egg, 2% skim American cheese sandwiches on whole wheat English muffins; 1 cup coffee; 1 small cranberry juice
• Lunch:
• Dinner:

Weather

Workouts:

Stats:

Post work out vitals:

Workout Notes:

Total Headaches Today:   0
Time of CH attack onset: 
Method of Abortion:

Notes (Updated)

Got stuck working late tonight.  Was at work from 6:30 am until 9 pm.  Was not happy about it.  Put me on the metro right in the middle of my first daily CH attack window, which fortunately appears to have been averted by the 8 pm prophylactic use of Sumatriptan.  I did not get a headache tonight.  

Because of the late night, I didn’t get to work out and I ate dinner at 10 pm.  I went to bed around 11:30 pm.

Notes from earlier:

No attacks since 8:30 pm last night.  The Naratriptan (Amerge generic) is slow-acting, so although it failed to prevent the first attack it may have prevented subsequent attacks that would have occurred overnight.  Tonight I’m going to try the Sumatriptan (Imitrex generic), as advised by my Neurologist.  The Imitrex has a higher peak, quicker response, but shorter overall effectiveness.  I expect it to prevent in the 8-10 pm and 12:30-1:30 am attack windows I’ve been getting the attacks this cycle, but I may be waking up to a headache around 4 am. 

The treadmill is still taking down the attacks within minutes, so it’s not the end of the world if these meds miss an attack or two. 

Big question I hope to answer this week:  Is there a connection between full workouts and attacks returning?  I don’t know if I will be able to answer that this week, but I’m going to be working out every other night and will at least get a chance to have a look.  If there is a short-term connection, I would expect to have attacks on the nights I work out and not on the nights I do not work out.  If there is a longer-term connection, the expectation is that I will have attacks every night, including nights I don’t work out.  If there is no connection, I expect a pattern of attacks that is inconsistent with my workout schedule. 

I believe there may be a limited, indirect connection between my workouts and my cluster headache cycles.  I think there is a correlation, but I believe there is something other than the workouts causing the headaches.  Factors in my reasoning:

• A few months ago I worked out intensely for about 2 months before I had to discontinue due to an injury, and I did not get headaches then
• The current cycle started after I had been working out consistently for about 6 weeks
• Prior to the current cycle, I had gone 3 years without an CH attacks.  Although not consistently, I had worked out on and off during that period.
• My recent 2 night block without CH attacks occurred toward the end of a week in which I  did not have a full workout.  However, I had been running 1-2 times per night for at least 5 minutes at a time at a low sprint for CH abortive purposes up to the night prior to the headache-free block.  I believe the lack of CH attacks those two nights probably can be accounted for by the new medication I started taking prophylactically (Naratriptan), and had nothing to do with whether or not I was exercising.  The fact that I had an attack again after a few days of initial success is consistent with my experiences with all other treatments I have taken.
• Neurologist informed me that the research shows a connection between working out and a specific type of headache that I do not get.
• My attacks have consistently been aborted by running.  It doesn’t make sense that working out can be both the cause of and a remedy to the same condition.    

Vitals

• BP
• Weight:
• (Height): 6’3”
• Age: 38

Side Effects Experienced Today

• Slight light-headedness
• Started seeing stars around 9:15 am - like I looked at the sun too long.  Had a hard time seeing words on my computer screen.  Lasted about an hour.  

Activities

• Went to work today

Medications

• Taken according to schedule (see today’s post re updated prescription schedule). I took the am dosages at 7:30 am.
• PM dosages at 8 pm

Meals

• Breakfast: 2 lunchmeat turkey, egg, 2% skim American cheese sandwiches on Kaiser rolls; 1 cup coffee; 1 small cranberry juice
• Lunch: grilled chicken salad with manga salsa, black beans, avocado; small curry chicken soup; Cheezits; water
• Dinner:Turkey chili with red onions and cheddar cheese; pita and hummus; club soda

Weather

•  Not sure - I was inside all day.

Workouts:

•  Missed due to work

Stats:

Post work out vitals:

Workout Notes:

I think I figured out where the metallic taste in my mouth has been coming from: the unsweetened iced tea. It’s kind of strong stuff - Kuerig English Breakfast Tea. Think I’ll pick up some lemons. :)

Notes

The prophylactic use of the Naratriptan appears to be doing the trick. I’ve taken one around 8:00 pm the last two nights and have had no headaches. Still waking up several times to pee, but I’m not up for as long as when I was jumping on the treadmill in the middle of the night, and overall I feel like I am getting more rest. Today I slept in to 7:45 am.

House was only grazed by Irene. Still have power and cable, and nothing was broken. Most importantly, the motorcycle is fine! I just have a little yardwork to do later.

Last night my wife and I set up camp with flash lights, candles, and Monopoly in preparation for the power to go out. Put Star Wars on in the background to enjoy the power while we had it, making for an old-school, kids from the 70’s and 80’s evening of escape. Very fun and relaxing, although I don’t remember ever playing Monopoly with such a hottie when I was a kid! We never lost power - just had a few light flickers.

More details later.

Vitals

• BP @ 8:43 am: 124/72, pulse 49
• Weight: 204
• (Height): 6’3”
• Age: 38

Side Effects Experienced Today

• I have felt slightly light-headed for part of the morning; less so than yesterday
• Metallic taste in mouth from last few days seems to be fading

Activities

• Worked out at 9 am

Medications

• Taken according to schedule (see today’s post re updated prescription schedule). I took the am dosages at 8 am.

Meals

• Breakfast: 2 lunchmeat turkey, egg, 2% skim American cheese sandwiches on whole grain English muffins; left-over sweet potato fries; 2 cups coffee; 1 small cranberry juice; glass water
• Lunch: 2 turkey joes (leftovers from dinner); Cheezits and hummus, Kalamata olives; unsweetened iced tea
• Dinner: Turkey chili, leftover turkey joes, salad
• Dessert: strawberries and non-fat whipped cream

Weather

• Hurricane Irene came and went overnight and provided minor excitement and caused no damage or other major inconveniences.

Workouts:

9 am Treadmill run:

• 4 minute warm up at setting 4
• 15 minute run at setting 6
• 6 minute cool down at setting 4

Stats:

• Peak heart rate: 180
• Total run time: 25 minutes
• Calories: 255
• Distance: 2.3 miles

Post work out vitals:

• BP: 121/82, pulse 136
• Temperature: 96 (Clearly wrong. Need a new thermometer.)

Workout Notes:

The run felt good. It was the first run I’ve had in a few days, and the first full workout I’ve had since last Saturday. I think the 4 minute warm up made a big difference on my knees, which do not feel inflamed this morning. I could have run for longer and pushed it to 3 miles, but I decided to go ahead and ease back into it at 2 this morning. I’ll take it to 3 next week.

A few useful conventions:

• Footwear: I stopped wearing socks when I run and my feet feel better now. Running in Asics, probably a half to one size bigger than I should be wearing, but these are comfortable.
• Breathing: I breathe at a pace of two steps, inhale, two steps, exhale. I inhale and exhale through my mouth. Previously, I was forcing inhalations through my nose, and that made things difficult. I kept sucking my nostrils shut. Not good. Breathing much easier now, and it helps me focus on the running. I was also previously playing with different inhalation patterns, such as three quick inhalations then one long exhalation. I picked that up from a high school gym teacher I think. I think that method helps concentration a bit, making me kind of feel like a machine that I am in control of, but I like what I’m doing now more, still controlling the pace, but keeping a normal pattern of inhalations and exhalations.

Mini workout at 3:00:

40 push ups 20 bicycle crunches