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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for cluster headaches

I have recently been diagnosed with cluster headaches. I am 40 yo male. I take n2o medications and have no serious previous medical history other than injuries from sports etc. the headaches are the most intense pain i have ever experienced and in hospital when i arrive they ask me how bad the pain is i want to say ten out of ten, but think they would think i was a hypochondriac so i say 7 or 8. this is despite my eye swelling up, my nose running like a tap, my body sweating so bad i look like i have been for a swim. Photophobia is intense initially as is nausea but this resides after about 30 minutes. i can t sit down or lay down and must keep moving to deal with the pain. I feel the staff get annoyed with me because i can t sit or lay down like a compliant patient and must keep moving, pacing generally because ten oxygen tube is so short. And worry they think I am being difficult or trying to get sympathy. The headaches typically last about four hours. I have now had five in total. The first one was overseas 4 years ago and ive had nothing since until a year ago when i had the second one. Then suddenly in December 2014 it started again and i have now had another three in the last 6 weeks. The thought of having another one makes the pit of my stomach tighten up and causes me to feel quite down and hopeless, because i just can’t stand the thought of that pain again. The last three headaches have seen me end up in the emergency department and with my treatment consisting of IV fentanyl, intranasal fentanyl, intranasal lignocaine, sub cut imogran, IV largactil, oxycodone tablets, ibuprofen tablets and oxygen. However the headache just continues on until it is ready to stop, and then it s gone as quickly as it arrived. Although the largactil and IV opioids do help, even if only for ten minutes, its enough to take some deep breathes and get ready for the next onslaught. When the first one happened 4 years ago i was on holiday in Hawaii. I went to a doctor s surgery with my wife and the doctor gave me an injection of pethidine into my butt and although it did not get rid of the pain, it did something and i was soo much more comfortable and i returned to my hotel room and after four or five hours, i was back to normal although very vague and exhausted. The frist couple of times they happened in Australia and I went to the hospital I asked for pethidine and soon found this was a big mistake - drug addict si what they thought. How can i suggest this treatment without sounding like an addict and that is all that i am after? The pain is just too much to bear and not knowing when it will happen again and how long it will last and if I will be like this for the rest of my life is all very distressing stuff. I just want to go back to normal./ My life was good and i enjoyed life. Everything has changed now and I am scared out of my wits of this pain and when it hits i just want them to knock me out of it and i have even begun thinking what i can do to make myself unconscious. it just frustrates me that In think there is something that seems to work reasonably well for me but the treatment causes you to be seen as one of societies most hated people - the junkie ! How can this be fair or right? Please help me and suggest something I could do or try? Is there anything I can do quickly when i feel the headaches coming on? Usually it is intense pain behind my eye and my mouth goes incredibly dry and I get very thirsty and then the headache hits about ten mins after that. My wife is a RN and can give needles. Please help me?
Wed, 25 Mar 2015
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Orthopaedic Surgeon 's  Response
hi
really it is a perplexing problem and wonder what neurologist say about this
I would suggest you to try alternative therapy like accupuncture
i believe you might have got brain scans,EEG,Paranasal sinus check ups and eye and tension causes ruled out already including migrain and blood pressure.
Another thing I may suggest is talking to a paranormal psychologist and a psychiatrist and also accupuncture, faith and spiritual counselers.
When no investigation have given a clue, oxycodone ,perocet,vicodin are symptomatic remedies, maybe you have no other choice for now-
alternative therapies sometimes bring wonder results- so be hopeful and try

best wishes,
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Suggest treatment for cluster headaches

hi really it is a perplexing problem and wonder what neurologist say about this I would suggest you to try alternative therapy like accupuncture i believe you might have got brain scans,EEG,Paranasal sinus check ups and eye and tension causes ruled out already including migrain and blood pressure. Another thing I may suggest is talking to a paranormal psychologist and a psychiatrist and also accupuncture, faith and spiritual counselers. When no investigation have given a clue, oxycodone ,perocet,vicodin are symptomatic remedies, maybe you have no other choice for now- alternative therapies sometimes bring wonder results- so be hopeful and try best wishes,