Long story short (ish), my significant other has been battling headaches (which have been called cluster headaches at one point and hemicrania continua at another) off and on for a year, and has seen one neurologist here who was not very helpful and one in AZ (where we work in the summer) when the headaches weren't as bad.  Sometimes they follow what I think is the correct pattern for CH (come on suddenly and are interuptive to devastatingly painful, wake him up at night, he can only pace/rock/pound his fist etc), but for the past month it seems as though he has a medium to horrible background headache ALL THE TIME.  He has been on endomethicin, gabapentin, mirtazipine, and probably a couple I'm forgetting.  He has an appointment with a different neurologist in town (Missoula MT) but not till January, and despite our begging they can't get him in sooner.  They suggested he go to the ER and see the on-call neurologist.  His primary care doctor doesn't really know what to do with him and has given him Imitrex tablets (which don't work) and a refill on the gabapentin.  I'm pretty much at my wit's end here.  He's in grad school and supposed to finish this year, but things are looking pretty hopeless unless we find some relief for this.  Does anyone have input/advice on who to see/what to do in the meantime?  Visit the ER?  Call every neurologist in town (as far as I know they all have month long waits)?  Sorry to post without doing a lot of background reading, or if this is kind of a ramble, but I'm at work and slightly desperate--his mental health is seriously suffering, not to mention the pain.  I can't even imagine what you all go through. 
Thanks in advance for any advice.
Jen

Has he tried oxygen?

     Potter

Not yet, but from what I'm reading that might be the next thing to try, eh?  The GP he's been seeing mentioned it in reference to another patient in town who had cluster headaches, but no one is sure if that's what he has...

check your pm box.

            Potter

Another vote for oxygen!

Marc

oxygen!  in the meantime, get him some red bull, 5hr energy (my pref), or another energy drink containing both caffeine and taurene.  have him slam one down at the first sign of an oncoming attack.  it will usually knock back a hit to a manageable level or kill one if i get to it quickly enough.

jerry

Items 4 & 5 are likely to be the most productive but I'd not by-pass the other suggestions.
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LOCATING HEADACHE SPECIALIST

1. Search the OUCH site (button on left) for a list of recommended M.D.s.

2. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

3.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

4. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE; On-line screen to find a physician.

5. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE Look for "Physician Finder" search box.  Call 1-800-643-5552; they will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

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As you have discovered, supported by our extensive experience here, is that most neurologists don't receive the training or have experience in treating complex headache disorders. You would expect this speciality to be the group to turn to but even formal medical research confirms their lack of training.

Self-diagnosis is a problem becasue so very many disorders mask/present as headache. So, first step, is to try and find someone with skill.

Thanks everyone--this has been scary and miserable for me, so I can't imagine how he feels. 
-Jen