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ICH: instigator vs perpetuator

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Intracranial hypertension may work like that. Venous sinus stenosis

shows up in a lot of patients and some say that this is a kind of

common final pathway for ICH. It may start for a number of reasons,

but once the stenosis is established the pressure backs up on the

arachnoid villi and may make the ICH self-perpetuating. It seems like

it sort of *has* to be that way. I've read an account of a physician,

for example, who woke up from general anaesthesia with what became

chronic ICH. Various compounds like excessive vitamin A, antibiotics,

etc can do this. Lyme, and probably other forms of

infection/inflammation can do this. In my case, I think head trauma

set it off, though I'm quite uncertain about that. In most cases the

initiating insult can be long gone with the ICH chronic.

I'm not big into mathematical/computer modeling of biological

illnesses, but insofar as the ICH field is embracing this more-or-less

plumbing/hydrodynamic view of at least a subset of ICH I think this

paper (a day or two old) may be on to something:

" Simulations predict that a temporary perturbation that causes a

transient elevation of ICP can induce a permanent transition from the

normal to the higher steady state. "

http://tinyurl.com/33xw57

>

> That is weird. As you know I usually emphasize the thought that some

> factors involved in a disease's genesis may not be involved in its

> perpetuation,

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Matt, did you say you tried Diamox?

I am seeing the first neurologist (he was better - didn't call it a

tension headache) tomorrow. I'm worried he will decide I have

polymyalgia rheumatica and try to get me to take steroids.

I'm really feeling incapable of defending myself at this point as the

head pressure does get bad under stress which then makes the doc

think I have tension headache. I am not winning here.

a

>

> Intracranial hypertension may work like that. Venous sinus

stenosis

> shows up in a lot of patients and some say that this is a kind of

> common final pathway for ICH. It may start for a number of

reasons,

> but once the stenosis is established the pressure backs up on the

> arachnoid villi and may make the ICH self-perpetuating. It seems

like

> it sort of *has* to be that way. I've read an account of a

physician,

> for example, who woke up from general anaesthesia with what became

> chronic ICH. Various compounds like excessive vitamin A,

antibiotics,

> etc can do this. Lyme, and probably other forms of

> infection/inflammation can do this. In my case, I think head

trauma

> set it off, though I'm quite uncertain about that. In most cases

the

> initiating insult can be long gone with the ICH chronic.

>

> I'm not big into mathematical/computer modeling of biological

> illnesses, but insofar as the ICH field is embracing this more-or-

less

> plumbing/hydrodynamic view of at least a subset of ICH I think this

> paper (a day or two old) may be on to something:

>

> " Simulations predict that a temporary perturbation that causes a

> transient elevation of ICP can induce a permanent transition from

the

> normal to the higher steady state. "

>

> http://tinyurl.com/33xw57

>

>

>

>

> >

> > That is weird. As you know I usually emphasize the thought that

some

> > factors involved in a disease's genesis may not be involved in its

> > perpetuation,

>

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>

> Matt, did you say you tried Diamox?

Two whole days. First day was 125 mg. Second day 250 mg. This is

quite modest. I started cramping up, including my throat. The

throat thing happened all of a sudden. I spoke to my boss and the

voice that came out was a boy's. His eyes got a little big; my did

too; we pretended it wasn't happening and I left early. It got a

little scary since I didn't know how bad the cramp was going to get

and if I was going to have problems breathing. (At least I assume

it was a cramp in my throat. If it was an allergic reaction then

another go of diamox is going to be interesting).

I think this can be dealt with by playing around with sodium and

potassium. I'm close to trying diamox again. Veterans keep saying

that the worst of the diamox symptoms dissapate a bit after a couple

of weeks, so I plan on easing into it. Turns out that Prilosec

inhibits CSF production at the choroid plexus,:

http://tinyurl.com/35q2qk

http://tinyurl.com/2w3t2e

....so I'm looking into the possibility of a combo. I haven't looked

yet at the mechanisms of the two drugs to see if they would merely

be redundant (and not worth the trouble) or additive. Some people

with ICH take prilosec to combat the acidity that builds up in the

stomach due to diamox, but they didn't mention if they thought it

was also, serindipitously, helping their ICH.

>

> I am seeing the first neurologist (he was better - didn't call it

a

> tension headache) tomorrow. I'm worried he will decide I have

> polymyalgia rheumatica and try to get me to take steroids.

Have you ever tried steroids? I took a bunch for an allergic

reaction and at the end of the taper I was feeling fantastic.

Steroids reduce CSF production at the choroid plexus, just like

diamox and prilosec. I wouldn't do the steroids long term in light

of the risks of diabetes, skeletal wasting, etc., but it was very

informative just the same. As you know, Lyme loves steroids, so I

won't belabor that point....

>

> I'm really feeling incapable of defending myself at this point as

the

> head pressure does get bad under stress which then makes the doc

> think I have tension headache. I am not winning here.

This is why the loose talk about " stress " over at CFSFMexp is so

unwise. Why would you put that gun into the hands of trigger-happy

physicians? If the stress of an office visit causes your head

pressure to flare, and you want to be evaluated for ICH, then just

say that the pressure waxes and wanes throughout the day (which

presumably is true to some extent for you; this is called pulse

waves, or wave forms in the ICH field; I'm quite cognizant of mine--

my head starts aching more, I get more hyperacuisis and fatigued,

etc.). He/she doesn't need to know that you believe stress is

aggravating your headache.

>

> a

>

>

>

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