Try staying on the O2 for 5-10 minutes after the h/a is completely gone. Many here report this helps eliminate rebounds.

It is best to stay on the o2 for at least half the amount of time longer than it took for your pain to be completely gone.  So, if it took 6 mins for you to be totally PF you should stay on the o2 for at least an extra 3 mins.  I usually decrease my flow rate a bit and breathe normally for that part of the process.    

I hope it works for you.

Ahhhhh...  I wondered if that was what I was doing wrong....  I sure hope it helps.. I'm sure I'll be reporting in!

Also, on a funny note...  of course my gen dr. says 'OH YOU CAN'T GET MORE THAN 15lpm UNLESS YOU GO TO THE HOSPITAL'.. so i take the Rx (for 10-15 lpm) in hand to medical supply and they flip out too!  I ended up with 2 tanks/regulators that only go to 8 lpm, piggytailed to give me 16 lpm...   whatever works, I say : )

You can buy a regulator that goes up to 25lpm on eBay for around $35-40.

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I bought this one.  I like it even more than my  reg that goes up to 25lpm.   Attaches easily to my M tanks.

2 things, I too have bought a couple of regs off E-Bay, my wife is always watching for them.

I used to get the comebackers within half an hour of turning off the 02. I tried staying on it longer, no good, they still came back. I used to take a cafergot with my 02, it pushed back the rebounder up to 12 hours. Now I drink a Red Bull with my oxygen, it speeds the abort time and seems to works almost as well as the cafergot at preventing the come backer.

Joe

For me I'd rather stop 10 minor attacks with O2 than go through one full blown attack.

Don

Don, I couldn't agree more. And just for the record, there is a difference between what we tend to call rebounds and what may in fact be a new headache. In any case I have found what Joe says to be true for me as well...hit it with an energy drink and the little bastards seem to be minimized. Blessings. lance

Ya one of the many ways this board has helped me is reminding me to stay with the O2 for a few minutes after the pain is gone.  It seems intuitive enough but still, quite often I would just want to get back to my day (or back to bed) asap.  I too use to get a lot of rebound attacks...though I dont think they were "rebounds" per se, just the beast still had a step or two left in his dance.  Staying with the O2 for a while longer reduced this problem considerably for me!  Good luck!

(and I do hope you can find yourself a higher flow regulator....still astonishes me that so many doctors and suppliers are so shocked and unwilling etc....what is the concern anyway?...they dont bat an eye at prescribing some pharmaceutical with unproven efficacy and potentially dangerous side effects, like throwing darts sometimes, but balk at high-flow O2 which as far as I can tell only makes one's mouth/throat very dry...hardly a dangerous side effect??)

  I'm getting ready to order another regulator . . . 25 lpm this time.  I have two 15 lpm regs . . . the one I keep by the bed does a fine job and I'm able to hyperventilate with it.  The one I keep in my vehicle comes nowhere close . . . so either the home unit is putting out more than 15 lpm or the other is putting out considerably less . . . which will be corrected soon.

  I too am really frustrated with docs and their attitude towards 02.  My current doc (who has two other CH patients), doesn't prescribe because "insurance won't cover it".  He knows I use it to abort and have shown him my O2ptimask (Med supply is working off a 9 yr old script from previous doc whom I deluged with info off this site).  I getting an appt with another doc (my daughter and grandson's doc)  . . . especially since she relayed my dissatisfaction with current doc's attitude about 02.  His reaction was "just because insurance won't cover it is not a reason to refuse a prescription".  If he is as open to CH info as I suspect, will be adding him to the recommended doc's list.

  I am really sold on the energy drinks (I like Rock Star orange or lemonade) . . . seems to greatly reduce the abort times and save me some 02.

  Be Safe,   PFDANs

    Richard

Anything more than 15lpm via nrb is a waste.
That will give you about a 95-98 % oxygen.

25lpm will just blow off.

A demand valve is also relatively useless.

Stop wasting time and $$  searching out any other stuff, or falling for marketing hype

ronkh wrote on Aug 8^th, 2011 at 3:23pm:

Anything more than 15lpm via nrb is a waste. That will give you about a 95-98 % oxygen. 25lpm will just blow off. A demand valve is also relatively useless. Stop wasting time and $$  searching out any other stuff, or falling for marketing hype

Bullshit.

On all counts.

Brew wrote on Aug 8^th, 2011 at 3:47pm:

ronkh wrote on Aug 8th, 2011 at 3:23pm: Anything more than 15lpm via nrb is a waste. That will give you about a 95-98 % oxygen. 25lpm will just blow off. A demand valve is also relatively useless. Stop wasting time and $$  searching out any other stuff, or falling for marketing hype Bullshit. On all counts.

I agree with Brew.   My reg that only goes up to 15lpm doesn't allow me to hyperventilate.  The 25lpm reg does better but the welder's reg I have is my favorite.   I can be PF in about five minutes using it. 

Welcome to the board Ronkh. I assume you are a doctor or perhaps one of the many un-educated oxygen suppliers who still argue with what most of us now know is the truth. 100% oxygen, at a rate to support hyper ventilation, will slay the beast in a matter of minutes.

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Read this, it will prevent you from making such incredibly un-educated, false, misleading statements in the future.

joe......who is not prone to violence but if you try to take away my demand regulator...it's on! ;)

Demand valve *may* be helpfull, who prefer to hyperventilate....  But in most cases a NRB @ 15 lpm will deliver the correct amount of oxygen.

If you think I'm foolish get a pulse ox meter and see.  (for the un educated, ya can't get higher than 100% SAO2)

And for the most part, what I see in this board is some of the older members are too blind/jaded or making money off some of these products or advertising.

If you look at my join date, it's over a couple of years.  Having suffered from CH for over a decade.  And having gone through miss diagnoses from dental problems, to sinus probelms, I can feel for most of the people here.  But Again, IMHO there seem to be some people that may have a profit incentive instead of compassion.

Dem's some cojones, pal.

Ronkh......you are  making the same mistake many doctors make when they insist on sending us for saturation studies to justify our getting oxygen prescribed. It is not the oxygen percentage in the bloodstream that seems to abort our  attacks, it is rapidly hyper ventilating with 100% oxygen.....which the majority of people CANNOT  do with a 15 LPM flow. The bag will be sucked empty the majority of the time, you will then draw in outside air, diluting the 100% oxygen....drastically lengthening the abort time.

To ALL  people reading this....I rarely take this strong a stance on stuff on the board. THIS MAN ABSOLUTELY HAS NO IDEA WHAT HE IS TALKING ABOUT. PLEASE, PLEASE IGNORE EVERYTHING HE IS POSTING ABOUT 02 FLOW, HE IS NOT A REGULAR TO THE BOARD, HAS GIVEN ABSOLUTELY NO BACKGROUND TO GIVE HIM CREDIBILITY AND HE IS DEAD WRONG.

Joe

PS: I'm retired and have NEVER worked for an oxygen supply house or in any way make money off of 02 or it's equipment.

You tell him SARGE!

I'm in 200% agreement with Joe.

And I've no connection with any oxygen supplier in any way other than using their products at 25lpm to kill my CHs in minutes.

Quote:

But Again, IMHO there seem to be some people that may have a profit incentive instead of compassion.

While I see nothing humble in your opinion I am curious...exactly what is it you recommend? It smells like you have something to peddle but perhaps I'm wrong. Still, it is easeier to tear something down than it is to offer a constructive opinion. lance

Hey Ronkh,

Thanks for bringing up the topic of oxygen flow rates...  You're quite right...  a flow rate of 15 liters/minute 100% oxygen will saturate blood hemoglobin...  in fact, it only takes a flow rate of 7 to 9 liters/minute with 100% oxygen to do this when using a fully functioning non-rebreathing mask and remaining motionless...

Unfortunately, neither flow rate provides sufficient lung ventilation to remove excess CO2 that will build up when using a non-rebreathing mask with any physical activity...  such as doing the cluster two-step dancing around the oxygen cylinder, rocking back and forth in a fetal position, or headbanging... 

I'm sure with your knowledge of respiratory physiology, that you already know what happens when CO2 levels climb above normal...  that elevated CO2 levels results in the hypercapnia that stimulates among other things, increased respiration, elevated heart beat and vasodilation as the result of the body's homeostatic mechanism that controls arterial pH... and that under these conditions even while breathing 100% oxygen, the cerebral vasodilation is so great that an abort of a cluster headache may not be possible... 

It's also likely you're aware of the respiratory alkalosis that occurs during hyperventilation, where the pH of arterial blood climbs above normal when CO2 is cast off faster than it's generated by normal metabolism, and that hemoglobin has an increased affinity for oxygen when arterial pH is higher than normal...  Remember the Bohr Effect?  This is where hemoglobin can actually attract and carry more oxygen molecules than at a normal arterial pH of 7.35 - 7.45. 

But then you're probably also aware that most of the finger pulse oximeters are only calibrated to .99 or 99% SpO2 like the MD300C1 I've owned for over four years... so it's impossible for them to measure any higher level of oxygen saturation...  That requires BGA - blood gas analysis...  a far more invasive procedure with sophisticated equipment that measures the partial pressure of blood oxygen (PO2) and carbon dioxide (PCO2) concentrations in mm Hg. 

There are several studies that have shown that breathing 100% oxygen under normocapnic conditions (normal respiration with normal CO2 levels) results in a PO2 of 570 mm Hg and that breathing 100% oxygen under hypocapnic conditions (hyperventilating to reduced CO2 levels) results in a PO2 of 585 mm Hg.  If you converted that PO2 to an equivalent pulse oximetry value it would equal an SpO2 of 1.03 or 103%.

It's also interesting to note that the hypocapnia and increased arterial pH associated with the respiratory alkalosis that results from hyperventilation stimulates a level of cerebral vasoconstriction similar to that stimulated by sumatriptan succinate (imitrex), but greater in magnitude than the cerebral vasoconstriction induced by hyperoxia at normocapnic levels... 

Moreover the combination of hyperoxia, hypocapnia associated with respiratory alkalosis with symptoms of paresthesia resulting from voluntarily hyperventilating with 100% oxygen can produce a very rapid increase in cerebral vasoconstriction with cluster headache aborts up to three times faster at better than 95% efficacy, than oxygen therapy at a flow rate of 15 liters/minute.

I do want to thank you again for bringing up the topic of oxygen therapy flow rates.   We wouldn't want perspective or current oxygen therapy users to avoid using the more effective oxygen flow rates of 25 to 40 liters/minute that can abort their cluster headaches so much faster and more reliably than the lower oxygen flow rates.

Too many physicians and neurologists who prescribe the lower oxygen flow rates for cluster headache sufferers thinking it's sufficient to achieve the hyperoxia needed to abort a cluster headache have apparently forgotten their course in Respiratory Physiology 101 they took in med school. 

In addition, unless they served prior military service as a pilot or flight surgeon, it's also likely they were never exposed to aviation physiology or aerospace medicine so it's understandable that they're unaware that repeated exposure to breathing 100% oxygen at flow rates much higher than 25 liters/minute is quite safe...  In fact, Navy and Marine Corps pilots flying the F/A-18s do this routinely up to three times a day/night breathing oxygen from takeoff to landing on missions lasting 2 hours.

Oh yes... one last point...  as a CH.com Newbie, you might want to attend a few of the conventions and meet some of the regulars who routinely provide assistance to fellow CH'ers in need before you opine that we're jaded or selling something.  I don't know anyone who comes here to make money and all of us volunteer our time freely...  We also make donations to CH.com and OUCH.  Have you made yours?

Take care,

V/R, Batch

Holy shit "BATCH-MAN" (in robin's voice)...You took the words right out of my mouth (word for word)  :) :) :) :) :).....with much respect for everything you do for us.....Lenny

Lenny wrote on Aug 9^th, 2011 at 3:46pm:

Holy shit "BATCH-MAN" (in robin's voice)...You took the words right out of my mouth (word for word)  :) :) :) :) :).....with much respect for everything you do for us.....Lenny

;D ;D ;D ;D ;D

Lenny wrote on Aug 9^th, 2011 at 3:46pm:

Holy shit "BATCH-MAN" (in robin's voice)...You took the words right out of my mouth (word for word)  :) :) :) :) :).....with much respect for everything you do for us.....Lenny

Couldn't have stated my regards and thanks any better!

What???? Batch said the same thing I did!.... ::)....mostly...he just uses bigger words! ;)

Thanks as always Batch, knew you had my six.

Joe

I'll call BS on the idiot's post.  Not only do I not profit from O2 I have to pay for my own as I cannot get insurance to cover it most of the time.  I also had to pay for my O2ptimasks (2) and two others I bought for newbies that needed help.  I couldn't get a 25lpm regulator from my med supplier, so he gave me 2 15 lpm regs and we used two M tanks with a Y connector.  Not only can I breath all of the O2 provided in an attack of K7 or higher I'll suck the bag flat and be sucking for air at 30lpm.  This will kill hits within 5-8 mins.  Years ago when I tried using 15 lpm I gave up because I was sucking it down for up to 30 mins at a time or relief.  I quit using it and thought it didn't work because my hits normally last 30-45 mins.

To anybody new to the O2 regimen please pay no attention to this moron.  (I can't call him a troll although he is acting like one).

Jerry