The last 6 days of my life sucked.  I have been to the er and had 4 doctors apointments.  I am at the peak of my clusters and just filled up with medication.  I had an attack yesterday and went to the er, came home, and a few hours later the monster was back. I am currently on prednisone 20 mg, verapamil 120 mg,  sumatriptan 25 mg.  I also have been reading alot in these forums and purchased some Bronkaid, Vitamin D3 10,000iu and omega-3 fish oil.  I also have redbull in the fridge and the treadmill out for exercise.   My wife has a cpap machine that I can hook my oxygen to.  However my regulator only goes up to 8.  I have to order the correct regulator, one on ebay i guess. I am now just sitting around miserably waiting for the next attack.  How long is it going to take to see if any of this stuff prevents an attack.   Also can I do something to the regulator to turn it up?

Welcome, sorry you landed here, but you are in good hands now.
Let me preface this by saying you need to check with your doctor first before adjusting medication... and it sounds like you will. Also sounds like he is a rookie when dealing with clusters.
The first thing is get the oxygen right. Read the oxygen infolink on the left.
Verapamil... you may have to double that, maybe triple it... maybe more. Your doctor should have given you instructions on stepping that up... if not, call him first.
Imitrex 25mg? I am assuming that is in pill form. We mostly use the injections at 6mg. This is an abortive, and pills work too slow. Again consult your doc.
Again, I stress, get the O2 right. It is the best abortive for most of us.
Keep tuned I am sure more will chime in soon.
Edit: Prednisone is usually given in 60-80mg for a few days then tapered. May work for the first time, but has a habit of stopping working. It is has very undesirable side effects and most don't recommend it. Again sounds like new doctor time.
And, I know of no way to get around an 8lpm regulator.
Keep reading, education will be your best friend.

im sorry to hear your having such a crappy fight with the beast.
your verapamil dosage is pretty low, i didn't start finding relief until i stepped up the dose to 360mg per day, and im now at 480mg per day.   it took me 9 days to notice a difference, and 12 days before i stopped getting hit all the time.  i think that is about the norm around here.
if you get a lot of wake up hits, you might try melatonin.  a lot of people can skip the night/early morning hits completely by taking 9mg or so at bed time.(i take 25mg, which is a little high)  its an OTC sleep aid, available at most drug stores and walmart. 

im assuming the sumatriptan is in pill form?  if so, you will find it almost useless with how slow it works.  if you can, try to get the injection or nasal spray.  they work much faster, with the injections working fastest.  i try to avoid using it as much as possible because of the rebound headaches it causes.

in the meantime, read read read and ask questions.  this community is one of a kind, the most helpful i have ever come across.
anyway, i hope you find relief soon!

I also agree with the others. It sounds like you got some of the right meds, but in all the wrong doses or forms. You gotta see a knowledgeable doctor !

O2 needs to be at a higher flow rate

Imitrex works ALOT better for most of us in injection form or nasal form (Only the injections work for me & 4 mg is enough)

Prednisone helps me too but only at a higher dose (60-80mg to start, then taper)

Verapamil (I no longer take because I could not tolerate the higher dose, but most that find it to be helpful are taking a higher dose than you are)

I'd recommend you GET TO A DOCTOR to minimize your suffering ASAP !! And plz don't alter your meds without consulting your doctor.

Good Luck !

Welcome to the board. Your verapamil dose is very low, CH'ers go as high as 960 mg a day to get relief, some have to combine it with lithium to get relief.

The pill form of imitrex is about useless for most CH'ers as the pain builds too fast for the pill to have any abortive effect.

Even the prednisone is at a low rate. We tend to do tapers, starting at 80 mg a day, while we wait for the prevent, in your case the verapamil, to build up to therapeudic levels. At 20 mg a day the prednisone doesn't help me at all.

My assumption is your not working with a headache specialist, your regimen speaks to a doctor who knows very little about CH.

For tonight, this has worked for a few. Disconnect the regulator. Run a line from the tank into a 55 gallon trash bag, tape the line air tight. Bunch the top closed with your hand. Open the valve slowly, fill the trash bag with oxygen. Exhale completely, put your mouth over the top of the bag, inhale as deeply as you can, pull your mouth off, exhale. Do this as fast and hard as you can, trying to hyperventilate on the 100% pure oxygen your huffing outta the bag. I think you'll be amazed at the speed of the abort.

Then get yourself referred to a headache specialist neurologist, get yourself an effective regimen. We'll help any way we can.

Joe

yes, definitely try to get the correct regulator and mask set up.  it seems to be the best abortive method available. 
in the meantime, something i find that helps along with the red bull is straight up hyperventilation.  do NOT do this with short quick breaths though, as that doesn't seems to make a difference.  what i do is stand or sit up, inhale deeply with my diaphragm so that my chest and stomach swell, and force the air out through my mouth very quickly while applying a little resistance with my lips.  it usually helps if i jump on it early.  an old Yogi taught me this, as well as about 30 or so more breathing exercises.

Guiseppi wrote on Oct 15^th, 2011 at 8:35pm:

Welcome to the board. Your verapamil dose is very low, CH'ers go as high as 960 mg a day to get relief, some have to combine it with lithium to get relief. The pill form of imitrex is about useless for most CH'ers as the pain builds too fast for the pill to have any abortive effect. Even the prednisone is at a low rate. We tend to do tapers, starting at 80 mg a day, while we wait for the prevent, in your case the verapamil, to build up to therapeudic levels. At 20 mg a day the prednisone doesn't help me at all. My assumption is your not working with a headache specialist, your regimen speaks to a doctor who knows very little about CH. For tonight, this has worked for a few. Disconnect the regulator. Run a line from the tank into a 55 gallon trash bag, tape the line air tight. Bunch the top closed with your hand. Open the valve slowly, fill the trash bag with oxygen. Exhale completely, put your mouth over the top of the bag, inhale as deeply as you can, pull your mouth off, exhale. Do this as fast and hard as you can, trying to hyperventilate on the 100% pure oxygen your huffing outta the bag. I think you'll be amazed at the speed of the abort. Then get yourself referred to a headache specialist neurologist, get yourself an effective regimen. We'll help any way we can. Joe

I am a 40 year old washed up carpenter with no health insurance until recently.  I just quilified for the indigent program out here and have an apointment on Monday.  I don't have a primary doctor and the latest apointment were with random people.  The ER doc I seen last night didn't have a clue either.  Anyway I was diagnosed with cluster in 2005 through an ER doctor.  with no health insurance I managed to get through those atacks.  Then about 18 months ago I went through another cluster cycle that lasted about 2 months.  I just took medicine the ER room prescribed.  (treximet).  So until recently I went 18 months PF.  This time around it seems alot worse and my life sucks.  My 5 year old was in tears at the ER with me last night.

Anyway I am borrowing my father n laws oxygen with the slow regulator  I know I need to see a neurologist and get help.  Please don't flame me to bad for what I am about to tell you.  I started having an attack so I cleaned the oxygen tank with peroxide where the tubing is suppose to go turned the tank on and sucked the oxygen like that. :-? My wife freaked out but it worked.  How bad is that for me?  All i know is my cluster is gone. I drank a red bull too  ;D

1. stock up on redbull or monster energy drinks w/ combo of 1000mg taurine and 80mg caffeine-must be slammed fast at onset of attack,

2. until you get o2 from doctor by prescription...go to a welders supply company and get a large 200 ft green tank of o2 with a cga 540 welders regulator, order the non-rebreather mask from the ch store and have it shipped overnight

3. get to a qualified doctor from the recommended list or call around headache specialists and inquire if they've treated those who suffer from ch's,

3-a. get your pred up to 60mg and taper down while verapamil is becoming effective-might take 2 weeks,

3-b. verap taper up-stabilize after 2 weeks-taper down about 2 weeks after your last attack/end of cycle,

3-c. get script for 02 according to o2 info tab on left side of your screen, must be high flow regulator to hyperventilate such as 25 - 60 lpm,

3-d. imitrex injections and nasal sprays are, as mentioned above, the only use for us CH'ers, get as much as you can of each by script and ask for samples too, keep refilling monthly even when not in cycle so you can stockpile for next cycle

4. log a diary of your triggers, times of attacks, etc for your better understanding

5. read and learn as much as you can endure while still making most use of your PF time w/ your family, work, etc

good luck, we are all here together and you are not alone

You won't get a good treatment plan or Rx for needed meds until you can line up a doc who knows headache issues. Two leads: contact you local hospital and see if they info about free/low cost clinics and then explore the second lead for help with meds.
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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. 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.

6. START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
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Go back to the first page of this site: Cluster Headache Help and Support › Medications,  Treatments,  Therapies › MEDICATION $ ASSISTANCE: 12 sources=UPDATE

Wont flame you at all sir, when the beasty comes, we do what we gotta do. Be careful you leave a sufficient gap...as I'm sure you're aware, too much pressure into the lungs they'll pop like a balloon, but I suspect you understood that or you wouldn't be posting now!

Hang in there and do explore the welding oxygen option.

Joe

Thanks for all the help and support..  I wanted to start asking questions but i just keep reading and eventually found some answers..  I don't want to jinx myself I just want to say I have had 3 attacks in the last 24 hours.  The kip was at about 6 on all of them and which is way less then before. :-?  Straight oxygen from the tank helped out tremendously for the last 2 attacks. I also have drank 2 16oz red bulls and started running on the treadmill when I felt something going on.  Anyway I am out of oxygen now and scared to death.  Out here in Pueblo on Sunday will be tuff trying to find oxygen.  I don't have the regulator either.  Monday can't get here soon enough. Peace    

Dirty, I am on the same boat as you without o2.  I refilled my large green 200 cubic ft "M" tank on Friday afternoon and am just about out.

Needless to say, my lunch break tomorrow/Monday from work will be travel time to/from welders supply for another refill.

Be aware of your triggers and avoid like a plague!

Ice packs, bag of frozen peas, cold wash cloths and face in front of A/C cold vent in car or portable fan, slam RedBulls at onset, etc...these alternatives may help you. 

Good Luck