DEAR DR. DONOHUE: My husband suffers from cluster headaches. They started in May 1998, went away, came back in October 2002 and lasted for three months. At that time a doctor prescribed oxygen, which helped relieve the pain and the length of time the headaches lasted. Since then, they have returned in November 2005, May 2007 and November 2007, lasting from six weeks to three months. My husband says there’s nothing new for them. Do you know of anything? — C.H.
A: Cluster headaches behave exactly as your husband’s do. They come in “clusters,” with many headaches a day, and they recur for days, weeks or months and then disappear for long spans. Invariably, they return. A cluster headache is a terrible headache with pain unimaginable to those who have never suffered one. They are one-sided headaches that usually center around the eye. The eye waters, and the nostril on the same side often drips. Pain lasts for 15 minutes to two hours and often wakens a person from sleep. The pain is so awful that an affected person has to get up and pace frantically until the headache leaves.
For treatment of a cluster headache, oxygen works well. It’s inhaled, so it gets into the blood quickly. I don’t know if your husband has ever tried sumatriptan, a migraine medicine. It’s available in a self-injectable dispenser and in a nasal spray. Both forms, like oxygen, get into the blood quickly for fast action. Zolmitriptan, another migraine medicine, also comes as a nasal spray and can bring rapid relief.
Preventive medicines for cluster headaches keep them from recurring so often. Verapamil, a heart blood pressure medicine, is one example. Lithium is another. So is the short-term use of prednisone.
The headache booklet describes the more common kinds of headache, like tension and migraine. Readers can order a copy by writing: Dr. Donohue — No. 901, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My sister, 59, has had a problem in her groin area since 1999 and has seen many doctors about it. No one diagnosed her problem until November 2007. It is called celiac disease. All she knows about it is to stay on a gluten-free diet. Can you give more information about the disease and some of the foods she can eat? — G.M.
A: Once thought to be a rare illness, celiac disease is anything but rare. It’s an intolerance to gluten, a protein found in wheat, barley and rye. Digestive tract symptoms are its hallmarks: diarrhea, stomach discomfort, bloating and weight loss. However, many symptoms not directly associated with the digestive tract also can occur — things such as anemia, early osteoporosis, iron deficiency, nerve disturbances and a skin condition called dermatitis herpetiformis.
Your sister shouldn’t be cut adrift with so little information and so few instructions. She needs a dietitian to guide her in how to avoid gluten foods. The Celiac Disease Foundation is a terrific source of information and help. Its phone number is (818) 990-2354, and its Web site is www.celiac.org. Have her get in touch with the foundation quickly.
The “groin” problem leaves me puzzled. I don’t know what that might be or how it might be related to celiac disease.
DEAR DR. DONOHUE: You wrote about angina and said people take medicines that ease the heart’s burden and open up clogged arteries. I would like to know what the medicines are that open up clogged arteries. — A.C.
A: That was a bad choice of words on my part. The medicines I had in mind don’t get rid of artery clogs, but they dilate arteries so that more blood can get through them. These drugs include nitrates, nitroglycerin and calcium channel blockers like Cardene, Procardia, Norvasc and many others.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.
c. North America Syndicate
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