Cluster headache provokes horrendous pain
DEAR DR. DONOHUE: My son has three or four cluster headaches a day. His insurance allows him only nine pills a month to control these horrible headaches. He uses Imitrex, and there is now a generic form of the drug, but it still has a high price. He does not have the income to pay such prices.
Will there ever be a cure for this headache? — R.
ANSWER: One thing about my life that makes me happy is that I don’t suffer from cluster headaches. The pain of this sort of headache raises it to the level of torture. A cluster headache is a one-sided headache, usually felt behind the eye. On that same side, the eye turns red, and tears flow from it. The nostril on that side often drips. It’s mostly a male thing. For every woman who has cluster headaches, there are five men who have them.
These headaches got their name because they come in clusters, a few to many times each day, and in clusters of days to weeks for months at a time. They go away, but they always return. Unlike migraine headaches, which drive people to lie down in a quiet, dark room, cluster headaches provoke people to pace about in a frenzy.
Medicines exist both for terminating the headaches and for preventing them.
Imitrex (sumatriptan) is one. It comes in a self-injectable form, which provides quick action. It is expensive, and I don’t know when the price will drop. Your son might find renting an oxygen tank more economical. Breathing oxygen through a face mask can often put an end to the headache. Perhaps his insurance will cover the cost. Lidocaine nose drops also work, and they aren’t costly.
Your son needs to concentrate on preventive medicines, taken when the headache has gone. Verapamil is a generic medicine whose price is modest, and it can stop the clusters of these headaches. So can prednisone. Two other preventive medicines are lithium and topiramate.
The booklet on headaches describes the more common ones and their treatment. It doesn’t deal with cluster headaches. 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 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: Is there some way to improve the sex drive? I am a 56-year-old man whose doctor reports that my testosterone levels are good, yet I do not have a sex drive. He has given me Viagra and Cialis, but they don’t help. I find it difficult to have an erection. Does my age have anything to do with this? — J.S.
ANSWER: Nerves, hormones, blood vessels and libido (the innate desire for relations) are interwoven to produce a successful sexual response. If the problem is a loss of interest, then the approach should be finding what’s causing it. Psychological problems like depression are often responsible. If the problem is a physical one, like the blockage of blood flow to the penis or nerve damage to that organ, then the medicines you mention can be helpful. If they are not, mechanical devices like an implantable penile prosthesis are a consideration, as are vacuum pumps. It sounds like your problem is one of disinterest. Your family doctor can suggest a specialist who can explore this with you.
Age is a factor in many physical problems that lead to erectile dysfunction, but 56 isn’t considered to be a very advanced age. If your general health is good, it shouldn’t be a contributing cause.
DEAR DR. DONOHUE: I sleep with my head covered up. My husband says it is not good for me. Is that true? — C.P.
ANSWER: What do you mean by “head covered up”?
If you put something over your head and face, I don’t think that’s a particularly good idea. It would interfere with breathing. If you cover only your hair, that won’t hurt you.
Why do you do this?
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.

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