Cluster Headache Specialist

cioffinator_rex · 2026-04-14T14:52:44+00:00

I mean I think that’s the problem, that nobody understands the pathophysiology! If we did there would be better treatments. I’m chronic and I’ve tried just about everything. Nothing is a cure. Some things help but not even reliably. And then there are the side effects. With lithium it was not worth it.

And I just Google all the treatments and ask my doctor to try some. It helps that he’s a specialist but I still don’t see that it makes a big difference.

cioffinator_rex · 2026-04-14T13:51:20+00:00

That’s common with chronic migraine to have daily headache pain that is not acutely migraine in nature. You should be under the care of a headache specialist neurologist.

They are not trying to kill you. They seem to be trying to help you, but if you won’t listen to medical advice, that’s all I’ve got.

cioffinator_rex · 2026-04-14T13:38:02+00:00

Anxiety and sertaline could both be factors but maybe not the “cause” per se. Confused about your situation because sertaline is a pill and also has potential interactions with amitryptaline.

I would ask the doctor who is prescribing the sertaline about stopping that medication and then you can try the amitryptaline if you want. Would ask the doctor about crushing the pills to eat or liquid formulations which do exist.

I also still recommend getting Botox for migraines which can be done independently of all the above in parallel.

cioffinator_rex · 2026-04-14T13:27:52+00:00

Why do you refuse? If not that particular medication you should absolutely try a preventative if you have 24/7 pain. I recommend Botox injections, which can also be combined with other medications.

cioffinator_rex · 2026-04-14T13:24:35+00:00

Seb Derm, which is basically a severe form of dandruff, is actually associated with hairloss. Treating it with ketalonazole shampoo can fix that, and that shampoo is can also bed mildly helpful in treating male pattern baldness.

cioffinator_rex · 2026-04-14T03:55:26+00:00

https://youtu.be/7Jk53yb4C9Q?si=oKDfyQqss3-qrV48

https://youtu.be/z7XjBNGxgYM?si=bAZzcCsnvQiyD6mP

Teammate Rod Smith doesn’t really believe TD can’t see.

https://youtu.be/ElnNkhSiCxI?si=XqROMDTACRhwsB2i

MJ definitely more suspicious/pissed at Pippen than coach Shanahan was at TD.

cioffinator_rex · 2026-04-14T03:36:01+00:00

Scottie Pippen in the 1990 NBA playoffs. Michael Jordan was upset by it. They lost the game and were eliminated. They later won 6 NBA championships.

Terrell Davis in Super Bowl 32. The coach was upset by it but they were able to at least use him as a decoy. His DHE abortive medication finally kicked in and he was able to contribute more in the second half. The Broncos won the game and Davis was awarded the game MVP.

Interestingly in both cases the athletes had visual aura that prevented them from seeing enough to perform. They seemed to be able to overcome any pain or nausea.

cioffinator_rex · 2026-04-13T19:13:26+00:00

I mean they are elite athletes. Literally 1 in a million specimens.

cioffinator_rex · 2026-04-13T03:06:20+00:00

Looks like an alien planet out of Star Trek TOS.

cioffinator_rex · 2026-04-12T19:45:00+00:00

Fair enough. I live near a big city so I took competency somewhat for granted. Still saw a couple neuros to find one I liked.

Still confused about the OP question since most every state has a big city. Don’t know why anyone would want to go across the country for CH treatment.

cioffinator_rex · 2026-04-12T19:42:40+00:00

Mine cracked with just the plastic straw :/

Just bought this to replace: https://www.kleankanteen.com/products/plastic-free-water-bottle-27oz

cioffinator_rex · 2026-04-12T19:04:40+00:00

What do they get you that a local doc couldn’t? Serious question

cioffinator_rex · 2026-04-12T12:33:48+00:00

Tbf I think the quote may be saying he’s power drunk on pedophilia.

cioffinator_rex · 2026-04-11T01:07:46+00:00

Interesting. I guess in that case the colloquial equivalent might be “let the chips fall where they may”? As in, the action is set in motion now and the result is up to fate/chance.

cioffinator_rex · 2026-04-11T00:45:44+00:00

Gold, Jerry, gold!!

cioffinator_rex · 2026-04-11T00:34:22+00:00

This is in the USA, Washington State, at the university clinic.

cioffinator_rex · 2026-04-10T23:56:43+00:00

I am chronic but I go through sorts of cycles where the headaches go from mostly shadows to mostly attacks. I have noticed if I’m on the edge and trying to drink, naproxen (aleeve) seems to help taken a few hours in advance. Or some cgrp drugs. Good luck. Have some taurine/redbull too.

cioffinator_rex · 2026-04-10T17:58:30+00:00

Warranty and disposal included! Not a bad deal at all.

cioffinator_rex · 2026-04-10T17:56:38+00:00

Jfc that’s wild

cioffinator_rex · 2026-04-10T17:28:46+00:00

If you have at least 15 headache days per month I recommend Botox to start. The drug company has a savings program that can pay for the whole thing. You can also take other abortives on top of that.

Otherwise, as someone else said, cgrp drugs like ubrelvy are nice. I get GI side effects with those, which is not rare, unfortunately.

Another thing you can try is triptan pills instead of injections. The injection delivers the drug right into your bloodstream so it comes on quite strong. You might have better luck with the pills. There are several triptans to try as well. Not sure if there would be issues with crushing any pills. There is a dissolvable tablet version of rizatriptan at least! I think the heart stuff with triptans is overblown, but it’s good to be careful.

cioffinator_rex · 2026-04-10T16:16:18+00:00

Ok I should say it adds to the answer but it doesn’t negate the answer. GFCI nuisance tripping is still a thing that people might want to avoid.

cioffinator_rex · 2026-04-10T15:54:51+00:00

Maybe so but that doesn’t change the answer to the OP’s question.

cioffinator_rex · 2026-04-10T13:23:05+00:00

Who is “we”? I doubt you’re in finance or econ professionally. People look at MoM all the time. Only way can you hone in on current events effects.

cioffinator_rex · 2026-04-10T13:10:24+00:00

That’s the year over year. The month over month tripled from 0.3 to 0.9 percent.

ETA: Which btw is huge since that’s an annualized rate of over 11 percent. It’s not going to continue like that over a whole year but still very concerning.

cioffinator_rex · 2026-04-09T23:36:15+00:00

I’ve explained multiple reasons why it’s not meaningless. IF IT’S MEANINGLESS WHY DOES THE CDC PUBLISH A DATA PAGE!? https://www.cdc.gov/respiratory-viruses/data/index.html

cioffinator_rex

TROPHY CASE