DEAR DR. DONOHUE: I’m a 37-year-old auto mechanic, and I never had a headache until this year. The headaches I’ve been getting have been unbelievable. I can’t sit still or lie down when I have one. My wife says I should be quiet, but it’s impossible. They last a couple of hours and sometimes they wake me up. I get two or three a day. I tried aspirin, Tylenol, Advil, Aleve, you name it. Can you suggest something for me? I thought it might be carbon monoxide in the place where I work, but they keep track of that very carefully. — J.C.

ANSWER: The description you give of your headaches fits cluster headaches. They’re called “cluster” because they come in clusters, as many as eight times in one day and for weeks or months at a stretch. Then they disappear, and they can stay away for as long as a year. Almost always, however, they come back. They’re short-lived, lasting from 15 minutes to three hours. The pain is indescribable. It makes people get up and pace around. This is the exact opposite of the way people react to a migraine headache. With a migraine, people seek a dark, quiet place where they can lie down until it’s gone.

The pain of a cluster headache is always on one side of the head. The nostril on that side becomes stuffed and may drip. The eye on the same side might redden and the eyelid swell.

Cluster headaches are more a male problem than a female problem. Men with them outnumber women 4 to 1.

Treatments for cluster headaches exist, and often are quite successful. Breathing pure oxygen through a mask for about 15 minutes can put an end to the headache. Medicines used for migraines often are quite effective for cluster headaches. Sumatriptan (Imitrex) and zolmitriptan (Zomig) work well. Both come as nasal sprays, which provide quicker action than oral medicines. Sumatriptan also is available as an injectable.

Verapamil (Calan), prednisone and lithium (Eskalith) are drugs are reliable medicines effective in preventing these headaches. Give up alcohol. It’s a trigger for clusters. So is smoking.

DEAR DR. DONOHUE: My husband has to go to the doctor at least three times a year to get his ears cleaned of wax. He knows it’s time to go when his hearing gets bad. I know I could do this for him. Please give me some directions on how to do it. — J.A.

ANSWER: Earwax has a function. It protects the lining of the ear canal from water and germs. Ordinarily, the ear cleans itself. It has a conveyor-belt mechanism that keeps emptying wax out of the ear. Some people produce excessive quantities of wax, while others have a defective conveyor belt.

Be careful and gentle when getting rid of earwax. I take it your husband doesn’t have a hole in his eardrum, or the doctor wouldn’t have been cleaning his ears. You’ll find a number of eardrops on the shelves of drugstores. These drops soften wax. Use them according to the instructions that come with them. Generally, they’re used for four days. Names include Debrox, Murine Earwax Removal and Mollifene Earwax Removing Formula. Pick up a small bulb syringe in the drugstore, too. Use it to flush the ear canal with warm water. Don’t use a cotton-tipped applicator to pry out the wax. You’ll push it in more deeply.

DEAR DR. DONOHUE: What’s a Charcot (shar-COE) joint?

ANSWER: It’s a joint, often the ankle, that has become severely deformed. Neuropathy — nerve damage — is the cause. Nerves damage interferes with the transmission of information to the brain. In this case, it interferes with the transmission of pain signals. Without that input, we neglect to move joints. Constantly maintaining one position is destructive to joints. The affected joint becomes locked in a grotesque position and loses function.

Diabetes often is a cause of neuropathy and Charcot joints.

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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