My eye is already swollen and bright red and my nose keeps running.  The pain was bad and getting worse, and I began my pacing.  Stupidly, I have almost nothing at my disposal.  I just downed a red bull, which seemed to dull the pain a bit to the point where the pacing stopped and I can write this, but I still do not feel able to concentrate enough to get work done.  I will try just about anything.  I took an oral triptan that I just so happened to have on me from my emergency stash when migraines used to be an issue for me.  Hopefully that works, but it'll be at least 45-60 minutes and I have no guarantees it'll get rid of it enough for me to work.  Anybody have any ideas????

Go out to your car and blast the A/C on high and stick your face in front of it and hyperventilate until you feel dizzy and don't stop until the pain is aborted.

Or if no car, no a/c in car...just go home!

-Gregg in Las Vegas

Thanks Gregg.  The Red Bull took the edge off and the oral triptan finally kicked in.  I do not feel normal, but I feel able to make it through the day or at least the next few hours.

I've got a good 40 minute commute home and wasn't confident getting behind the wheel.

Should this happen again, I'll try the a/c thing.  When they get bad, I just have trouble being in a confined space like a car.  I'm constantly moving around.  Thanks for the advice.

The A/C advice has helped me dozens of times in the past.
 
Until I got a different vehicle and the A/C went out which was HELL in Las Vegas during August and September.  In those times, I had to try RedBulls, Imitrex inj/nasal sprays or just go home.

Have you printed and distributed the "Letter to employer, colleague, etc" to your boss?  This might create some empathy, might not, worth the chance though.

Good Luck! ;)

-Gregg in Las Vegas

i can sometimes get by with just hyperventilating with long deep breaths.  it usually doesnt out right get rid of it, but its better than nothing.  the key for me is exhaling as much air as possible with every breath and then inhaling as much air as i can with every breath.  works better with a red bull.

AubanBird wrote on Feb 9^th, 2012 at 11:17am:

i can sometimes get by with just hyperventilating with long deep breaths.  it usually doesnt out right get rid of it, but its better than nothing.  the key for me is exhaling as much air as possible with every breath and then inhaling as much air as i can with every breath.  works better with a red bull.

Your explanation of breathing is EXACTLY how to hyperventilate o2 effectively; and in this case how one can breathe fast in front of the A/C in car.

-Gregg in Las Vegas

Oral triptans are slower acting compared to injection and that's why they are the least favored for Cluster.

And, no triptan will be as effective when taken after the headache is well or fully developed. Abortives work best when taken at the first sign of an attack.

Injection Imitrix is the gold standard for fast relief. Could it be used at work? (Quick trip to the rest room and you're fixed. BUT let the boss know that you are using a needle on the job!)

If injection isn't workable, a pill which is almost as fast acting (discuss with the doc):

Headache 2001 Sep;41(8):813-6 

Olanzapine as an Abortive Agent for Cluster Headache.

Rozen TD.
Department of Neurology, Jefferson Headache Center/Thomas Jefferson University Hospital, Philadelphia, Pa.

OBJECTIVE: To evaluate olanzapine as a cluster headache abortive agent in an open-label trial. BACKGROUND: Cluster headache is the most painful headache syndrome known. There are very few recognized abortive therapies for cluster headache and fewer for patients who have contraindications to vasoconstrictive drugs. METHODS: Olanzapine was given as an abortive agent to five patients with cluster headache in an open-label trial. THE INITIAL OLANZAPINE DOSE WAS 5 MG, AND THE DOSE WAS INCREASED TO 10 MG IF THERE WAS NO PAIN RELIEF. THE DOSAGE WAS DECREASED TO 2.5 MG IF THE 5-MG DOSE WAS EFFECTIVE BUT CAUSED ADVERSE EFFECTS. To be included in the study, each patient had to treat at least two attacks with either an effective dose or the highest tolerated dose. RESULTS: Five patients completed the investigation (four men, one woman; four with chronic cluster, one with episodic cluster). Olanzapine reduced cluster pain by at least 80% in four of five patients, and TWO PATIENTS BECAME HEADACHE-FREE AFTER TAKING THE DRUG. Olanzapine typically alleviated pain within 20 minutes after oral dosing and treatment response was consistent across multiple treated attacks. The only adverse event was sleepiness. CONCLUSIONS: Olanzapine appears to be a good abortive agent for cluster headache. IT ALLEVIATES PAIN QUICKLY AND HAS A CONSISTENT RESPONSE ACROSS MULTIPLE TREATED ATTACKS. IT APPEARS TO WORK IN BOTH EPISODIC AND CHRONIC CLUSTER HEADACHE.

PMID 11576207 PubMed

--------------------------------------------------------------------------------

Olanzapine has a brand name of "Zyprexa" and is a antipsychotic. Don't be put off by this primary usage. Several of the drugs used to treat CH are cross over applications, that is, drugs approved by the FDA for one purpose which are found to be effective with unrelated conditions--BJ.
=====
Since this abstract was first posted Zyprexa has appeared in some lists of recommended meds for CH. [BJ]

Thanks for the breathing advice.  I will try it the next time the situation calls for it.

I have read the employer letter and very much appreciate its merit, but I have not yet given it to my employer.  Though I have had several work days that have been effected by CH, I have somehow managed to get all of my work done either by staying late or coming in on weekends.  I am also able to close the door to my office if it gets bad.  So far, I haven't had a screaming/moaning/crying one while at work, so I can quietly pace in my office until it passes.  I'm trying to avoid any stigma (call me paranoid if you'd like) for as long as possible.  I'm also just a very stubborn person.

Thanks Bob.  I do have Immitrex injections, but they are at home.  I need to leave at least one at work at all times.  Trust me, I am learning from this mistake.

Maybe it just passed on its own without the oral triptan, or maybe the oral triptan worked.  I'm just happy it's over, and I pray it doesn't come back.

er,
Are you familiar with how to get 2 or 3 aborts from 1 inj aka the "Imitrex Tip"?

START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE

If you are not familiar or need assistance, PM me with your phone # and I will call and gladly walk you through it step by step.

-Gregg in Las Vegas

I actually just read about that yesterday on this site as I continue to navigate it more and more, but I admit to only skimming it to this point.  I have not used an injection yet (only got the prescription a couple weeks ago).  Without first testing how it effects me, I am nervous about not taking a full dose.  I am not a big fan of injections, and it would have to be at least kip 8 and more likely 9-10 before I considered it.  If I'm severe pain enough to be suicidal, I'm hardly thinking about splitting up my injection into several doses.  Are you able to state definitely that an injection of a lesser dosage is as effective? 

If you think so, I'll PM you now.

Back to my para 2, above: delay in taking an abortive out of fear, until you have a well developed attack, will markedlyl reduce effectiveness.

Deal with the anxiety by talking to your doc, perhaps, even giving yourself an injection while in the office under supervision, so that you can be comfortable that this is a safe med. You don't want to reduce the potential for relief by delaying use.

Eric,
90 minute phone call, hope it helped!

Hang in there! ;)
-Gregg in Las Vegas

The conversation was invaluable.  Thanks again for taking the time.

Eric