Clusters of Joy

Repeating globs of not-joy For most people, physical pain is a transient affair. Things like joint inflammation, minor injuries and headaches are generally brought under control with over-the-counter pain relievers, and life goes on. Chronic pain is a different story altogether, and even those fortunate enough to have the means to control it — even if that's just enough to get through another day — may find themselves attempting to explain an invisible monster.

Strong pain medications, of course, bring problems of their own; the personality-altering effects of certain prescription drugs are well known, and often devastating. But even in the complete absence of medication of any kind, pain has a peculiar way of coloring the world — or removing color, maybe — that isn't necessarily obvious to those on the outside. Pain also has a way of interrupting, if not preventing sleep, and sleep deprivation . . . well, I probably don't have to explain that one.

I mention these things because they've been on my mind — quite literally — for the past six weeks or so. It seems I've found favor among the Gods of Headache, who have seen fit to bless me with a particularly ferocious example of their handiwork. I'm referring, of course, to cluster headaches, which have plagued me now for thirty years, give or take. The good news is the gradual attenuation of this unfortunate neurological condition over time; what used to be an eagerly anticipated twice-yearly event is now likely to come only once a year, if it comes at all. It missed me last year entirely, but intruded again this fall for its customary eight-week visit.

I know a number of people who suffer with migraine-class headaches (a mistreatment of the m-word, I know, but I use it here for the sake of common familiarity) and wouldn't wish that sort of thing on anyone, but there are certain fundamental distinctions between a classic migraine headache and one that properly belongs in the cluster category. I won't unnecessarily belabor the subject here — there's an abundance of literature and other material on the subject already — but one key distinction is the effectiveness of certain pain relievers for migraine-type headaches, while cluster headaches don't respond to pain medication. In fact, it's more likely they'll be worsened by it.

Another notable difference — and a source of confusion in the context of medical diagnosis — is the cyclical nature of cluster headaches. They're so named because their occurrence is typically clustered about a particular slice of time, usually during a particular time of year. Although there are variations on the theme — including the nightmare scenario in which they become 365-days-a-year chronic — it seems there's a trend in recent years toward diagnosing any unusually severe headache as a cluster headache, especially when it involves one of the eyes. Headache awareness among medical professionals has increased dramatically since my initial doctor-visits many years ago, but there's still room for improvement.

It's probably worth mentioning, too, that where the typical migraine-headache episode culminates in an extended period of sleep, the average cluster-headache victim laughs — and cries — at the idea of sleep. At any quiescent state for that matter, because even sitting too long in a chair is likely to bring that familiar sensation of a hot fireplace poker in the eye, and then it all goes downhill from there. Legend has it that cluster headaches are more painful than those in the common migraine category, and although I have no way to compare the two, it wouldn't surprise me if that were true.

Anyway, I'm on the positive side of this year's cycle, so with a bit of luck the idea of blog-writing will become more appealing in the near future. Not that I'm blaming the recent lack of words entirely on the headaches; life does go on, sort of.

In any case, that's where things stand, in a nutshell, more or less, for now. That is all.



  1. Anonymous5:30 AM UTC

    Glad the light was at the end of the tunnel and not the train.

  2. Anonymous5:43 PM UTC

    My grammar parser is freaking out. This might mean (a) the light was at the end of the train, (b) the train wasn't at the end of the tunnel, (c) the light's name is Glad, or (d) you were at your wits' end, and shouldn't have been playing with the computer in the first place.

    Don't do this anymore, or I'll send your sister to live with you, k?