Hello and a big Thank You! to everyone on this site.
I have been getting CH headaches for over ten years now, but just got diagnosed with them yesterday.

Over the years, all the doctors that I have seen diagnosed me with seasonal allergies and put me on a regiment of constant antihistamines.
Every time a cycle came around, (about the same time every year),
I would go to the doctor, he would change my allergy medicine and the attacks would stop after a few days.
I was under the impression that the allergy drugs would stop working and that was the cause of everything.

I have been having what I now know were CH attacks for the past three days.
Yesterday I had one right after lunch.
I rarely have them that early in the day, but I had been so exhausted from attacks the pervious night, I fell asleep after lunch.
This is what I suppose triggered yesterdays attack.

After the very first attack, I contacted my allergist.
Well, my allergist was not able to work me into his schedule for a few days.
I even gave him a complete diary with all of my symptoms, pain index, environment, and time table.
Still nothing…
Finally after insisting, his office agreed to order a head CT at the local hospital yesterday.
While I was waiting for his office to call back with the appointment information, I fell asleep.
When I woke up with what I new was coming, I decided that I would rather have an attack in the ER than at my desk at work.

So, I drove myself to the ER and the CH attack started reaching its zenith just as I was parking.
(Pretty dumb move to drive myself, but I thought that I could make it before things got real bad.)
Sat in the ER waiting room rocking back and forth in a chair with my right eye and nostril pouring out fluid.
Unable to talk at this point, I went to the bathroom and blew my nose.
After a few minutes passed, I was between "waves" and decided to try and communicate with the ER staff.
I was able to say just a few words, "Sinus Headache" and handed them my driver's license.
It was pretty obvious that I was in bad shape and I then started sobbing uncontrollably. 

After about 15 minutes, which felt like 2 hours, my name was called and I went into one of the ER Triage rooms for further evaluation.
The triage nurse was sympathetic and said that she knew exactly how I felt since she was a migraine sufferer.
Right about then, my Wife came into the ER, found me, and was able to provide more information to the nurses for me.
Then the nurse sent me and my wife back out to the waiting room.

After about 20 minutes, I was on what I call "The good side of the attack" and the pain started to drop off dramatically.
Right about then, the nurse called us back and I got a bed.
Gave all my info / history to the nurse and the student EMT that was with her.
They left and a doctor came in about ten minutes later.

The doctor spoke with me for no more than ten minutes and then asked me if I had done any online research on my condition prior to coming in.
I looked and him with a perplexed look and responded, "no…" and asked why.
He said because I just recited nearly all of the symptoms for Cluster Headaches word for word!
At that point in time, he ordered a heat CT just to be on the safe side along with O2 + Saline IV.
After a few hours, my tests came back clear and I was released with a referral to a neurologist + an Rx for Verapamil.
Just knowing what my condition is was such a relief, but I still didn't know when this latest round of CH was going to go away.

Later on, the student EMT came back in and asked if he could get me anything.
I asked for some ice water and we got to talking.
It turns out that he has CH too!!!
He said that he didn't want to suggest that I may have that too since he was just a student, but he immediately knew what was going on when he saw my face.
How crazy is that?
After being misdiagnosed for years, two medical professionals correctly diagnosed me after no more than 5 minutes!
(By the way, my allergist's office has yet to call me back with that Head CT appointment...)


This morning I jumped online and did a ton of research.
That led me to O.U.C.H. and CH.com.
I'm so happy to know that I'm not alone…

Thank you!

Welcome to the board PT. Great that you finally got a diagnosis, sadly the length of time it took you to get that diagnosis is still all too common. I’ve had CH for 33 years, they haven’t killed me yet! You need an organized approach to managing them so they don’t manage your life. I use a 3 pronged approach, many use a similar approach:

1: A good prevent med. A med I take daily, while on cycle, to reduce the number and intensity of my attacks. I use lithium, it blocks 60-70% of my attack. Verapamil is the most common first line prevent, but watch the dosing, we tend to go a LOT higher then most docs are used to. If it doesn't have any beneficial affect consider asking the doc to increase it, some go as high as 960 mg a day to get relief. Don't increase without working with the doc as they have to watch your blood pressure.

Topomax also has a loyal following. Some have to combine lithium and verapamil together to get relief.

2: A transitional med. Most prevents, including verapamil,  will take up to 2 weeks to become effective. I go on a prednisone taper, from 80 mg to zero over a two week period to give me a break while my prevent builds up. Prednisone will provide up to 100% relief for many CH’ers but is harsh on the system and should only be used for short periods of time.

3: An abortive therapy, the attack starts, now what? Oxygen should be your first line abortive. Breathing pure 02 will abort an attack for me in less then 10 minutes, that’s completely pain free. Read this link as it must be used correctly or it will not work

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


Imitrex nasal spray and injectables are very effective abortives. I use the injectables, they’re expensive, and I rarely use them, mostly just when I get caught away from the oxygen. The pill form generally works too slow to be effective for CH’ers.

Go to the medications section of this board and read the post "123 pain free days and i think I know why." It’s a vitamin/mineral/fish oil supplement, all over the counter stuff, that’s providing a lot of relief for people who have tried it, it’s a long read, worth the time.

For now, get some energy drinks. Rock Star, Monster, any containing the combo of caffeine and taurine, chug it down as fast as you can when you feel an attack starting. Many can abort or at least really reduce an attack using these. Since you're on verapamil I wouldn't do more then one or two energy drinks a day as the taurine in it can interact badly with the verapamil.

Finally, visit our sister board for “alternative” treatment methods outside of mainstream medicine. As you’ll see from all the success stories on this board, there is something to it.

clusterbusters.com


Read everything you can on this board, if you are a CH’er, knowledge is your best ally. We’ll help you all we can.

Joe

Joe,

Thank you for taking the time to reply.

I just started the increased dosage of Verapamil last night.
It appears that the Verapamil may be working.
After two days of taking it, the attacks have decreased in intensity and duration.
That coupled with some of the other tricks that I have pickup on this site & O.U.C.H. have been priceless.
The Energy drink thing is SOOOOO effective!!!!

My first appointment with the neurologist isn't until May 9th…
Historically, my cycles have lasted no more than two weeks.
It is likely that my cycle will be over by the time I'm seen.
I have taken the O.U.C.H. Headache Diary sheets and am recording as much detail as possible.

Since my diagnosis, I have spent a bit of time online researching and reading as much material as I can.
I'm a bit freaked out by how text book my symptoms are.
(How the hell could I have possibly been misdiagnosed for so long!!!)
Reading posts of peoples experiences is also chilling.
All of these feelings and emotions that I thought were uniquely personal to me are everywhere on this forum.
That on to itself brings me quite a bit of comfort.

A few other personal details about myself:

In 1996, I was in a car accident that broke my pelvis in eight places and caused a plethora of other internal injuries.
I did not experience my first CH until a few years after that, but I can tell you that the pain of a CH attack is far greater than the pain that accompanied that accident.
When it is said that a CH is the greatest amount of pain that the human body can experience,
I can assure you if it isn't, I can not imagine anything else that could be greater.
The only difference of course being that a CH attack lasts for no more than two hours (for me anyway) and the pain caused by trauma lasts for weeks and months.

With this in mind, I thought that I had a pretty good understanding of pain levels.
When I had my first CH attack, I was dumfounded.
How in the world could a sinus headache brought on by allergies be this painful?
(I'm going to have a hard time getting over the TWO misdiagnosis…)
I then figured that I must not have a very good grip on pain levels if this "Headache" was able to take me down.

Because of the previous pelvic injuries, I have been seeing a pain management doctor for the past ten years or so.
This is to manage the daily "pain" that can occur due to my activity levels or the weather.
(I still consider myself to be young at 37 and refuse to let my injuries keep me from doing what I wish.)
Pain is in quotes since comparing the daily bone type pain to the pain of a CH attack is really quite silly.
Anyhow,  I told you that to tell you this.
My pain management regiment is an anti inflammatory called Mobic coupled with a pain reliever called Norco.
The Norco is taken as needed and I typically will take one in the morning and take more if necessary throughout the day.

Having dealt with pain so much in my life, I like to thing that I bring a unique perspective to the topic.
Narcotic pain relievers in general only work up to a certain pain level.
After that level, they just allow you to tolerate the pain.
I can still remember laying in intensive care and still feeling every bit of the pain even though I was being pumped full of the maximum allowable levels of Morphine & Demerol.
Throughout my CH episodes, since I have a prescription for pain medication anyway, I have tried to treat the attacks with them.
Of course this is a useless, as pretty much all pain relievers are for CH.
One thing I did find helpful.
I would chew up a Norco at the first twinge of a CH attack and it would reduce the intensity from a 10 down to a 9…
It cracks me up to learn how much more effective a freakin energy drink is over pain medicine!

Anyhow, that is more information that any of you probably cared to read.
With that in mind, I will end this post here.
Once again, thank you all for helping!

PTLeighton wrote on Apr 30^th, 2012 at 8:14am:

It cracks me up to learn how much more effective a freakin energy drink is over pain medicine!

That is a very wise thing to learn early.   :)


Joe does a great job of good coverage helping, so just

Welcome.

Anyhow, that is more information that any of you probably cared to read.
With that in mind, I will end this post here.
Once again, thank you all for helping!

Oh to the contrary! ;) Hearing the unique stories of each individual on this board is one of this boards biggest strengths. Let us know how your neuro appointment goes. Get all the footwork done so when the next cycle starts, you can make a few phone calls and get set up with oxygen and your prevents.

Joe

Since you are on the right track re. Dx and appt for a neuro, etc., there is little to add at this time except:

Many general neuros have little training/experience in the comlexities of headache. Ask about this docs background in headache. Print out the PDF file, below, and if he isn't working from this outline of common Cluster meds, it would be wise to consider an alternative..
===
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.

---

Thanks for the tips Bob!
I found a Nerologist that specializes in headaches that is only an hour & 1/2 away.
Got lucky and they had a cancelation for this Wed.   ;D
I wanted to try to be seen before my cycle is done and that appointment for the 9th would likely be outside of that window.

FWIW, my cycles are only about two weeks long and I typically will have a 11 - 24 month remission.
I honestly cannot imagine the torture of having Chronic CH.
Two weeks of KIP 10 CH attacks is terrible, but continuous....  :'(

Update...

Today is one of the roughest days for me so far.
After a couple nights of auto aborting hits, I had a full blown 10 last night.  :'(
(30 Minute tidal crescendo, flowing into a 20 minute all out torture session, and then a 30 minute tidal decrescendo into collapse.)
I think the physical toll of "The Dance" is catching up to me.
All day today I have had ghosting every 45 minutes or so that scares the crap out of me.

The silver lining of that oh so dark cloud is that I'm certain that I won't be in remission by the time I have my appointment with the specialist tomorrow.
The specialist is Dr. Neil Pugach and he is currently located in VA Beach, VA.
Anyone heard of this guy?
Resume looks good…
Graduated from BU Med School and practiced in West Los Angeles, CA prior to coming back to the Atlantic. ;)

If history is any indicator, I should have less than a week left in this cycle…
(Fingers crossed…)

PT,

It sounds like you're having a rough time and it doesn't really need to be that way...  The odds are you are vitamin D3 deficient and that deficiency is making your CH more frequent and more painful.   

When you see Dr. Pugach, ask him for the lab test for 25(OH)D, the serum level metabolite of vitamin D3.

Neil was our guest speaker at the OUCH 2007 Convention in Richmond, VA.

He'll likely start you on a prednisone taper and on verapamil as preventatives...  He will also likely prescribe oxygen therapy and sumatriptan succinate nasal spray or SC Injection as abortives...

Stick to your guns on the lab test for 25(OH)D...  The normal reference range for this serum level metabolite is 30-100 ng/mL, but we've had CH'ers with active CH testing as high as 42 ng/mL. 

The exciting news is CH'ers are going pain free on the anti-inflammatory regimen....  (100 out of 133 to date since last December for an efficacy of 75%). 

Of the CH'ers who have gone pain free and then gone in for this lab test, all have tested in a range of 60 to 110 ng/mL.   Most CH'ers are going pain free within a week to 10 days after starting this regimen although a few have taken longer up to 30 days. 

The time to a favorable response to the anti-inflammatory regimen with vitamin D3 appears to depend on the initial 25(OH)D serum concentration... and how fast it builds.

The following chart illustrates the relationship between cluster headache and serum concentrations of 25(OH)D.

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

As you can see, a vitamin D3 dose of 10,000 IU/day is adequate for most.  Roughly 10% to 15% of CH'ers need to use 15,000 to 20,000 IU/day vitamin D3 in order to go pain free.

The basic anti-inflammatory regimen is simple.  $35 at Costco or 20 cents a day for a five-month supply as shown in the photo below:

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

Take two of each a day as shown below...  It's that simple...  You can take this regimen in the morning or evening.

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Take care and please keep us posted.

V/R, Batch

Quote:

we've had CH'ers with active CH testing as high as 42 ng/mL.

I guess you can up that a bit - I was at 55 ng/mL with active CH.

Thanks for the extra info guys.
Unfortunately, I didn't get a chance to see in until after my appointment.

I had another hit the night before the appointment and then ghosting all day yesterday.
This sucked, but at least I knew for sure that I was "In Cycle" for my Neurology appointment.

Thanks for letting me know that Dr. Neil Pugach was a guest speaker at an O.U.C.H. event.
It is good to know that my doctor is part of our community.
He did recommend that I check out the O.U.C.H. site.
I told him that I had already checked it out and also told him the news of O.U.C.H. (US) closing its doors.

The appointment was thorough and I my diagnosis was confirmed.
He was very impressed that the ER Doc was able to identify my symptoms and diagnose the CH.
I'm very thankful for that ER Doctor and plan on doing everything that I can to let the hospital know how pleased I am.
(The ER Doctor's name is Kevin Taylor in case anyone wanted to know…)

Anyhow, I didn't really learn anything new at the appointment.
This site as well as the O.U.C.H. site did an outstanding job of educating me.
Since I am near the end of my current cycle, he decided that the use of any preventives would be futile.
He prescribed ALSUMA auto-injectors to abort any additional attacks.
I haven't has a chance to try them out, but just having something that is labeled "For Cluster Headaches" is peace of mind.

We came up with an action plan for the next CH cycle.
Keep Alsuma on hand to treat an attack, then contact his office to get an Rx for Prednisone called into my pharmacy.
That’s it…
Since my cycles are fairly short (2 weeks or less) and Verapamil takes two to three weeks to become effective, the Verapamil was removed as a treatment option.
He was dismissive of O2 treatments and said that his experiences has been that the O2 postpones the attacks and result in rebounds.
He told me that if the Alsuma worked, there would be no need of going through the expense and hassle of getting setup with 02.
He also had never heard of the whole energy drink thing.
I told him how effective it had been for me and he was surprised... 

Even though the Alsuma is pricey, I will end up still saving money on prescriptions.
He gave me coupons that limit the Copay for Alsuma to $4 and I'm now able to stop taking three other medications that I had been taking year round to prevent "Sinus / Allergy Headaches".

Thanks again to you all and I will update you as the saga continues.
(No hits last night and have had very few shadows today….) :D

Do check out the regimen Batch posted, I'm on it full time now. The best part is, even aside from CH, it's a healthy daily regimen.

JOe

Well, the Beast is Back!!!
Had a nice 18 month break fortunately.

This is my first cycle after being diagnosed though.
I got to implement the action plan that my Neurologist and I prepared.
The plan consisted of Alsuma injections as an abortive and then a course of dexamethasone steroid as soon as my doctor could call it in.

The Alsuma injectors worked like magic!
Beast be gone!!! (In 5 - 10 min anyway...)
Hear comes the fun little hiccups in our plan.
Alsuma is currently out of production until September 2015 and I only had four in hand.
My first attack in this new cycle happened on the eve of a monster snow storm that prevented the pharmacy from ordering in Imitrex
or me from picking up more samples from my doctor.  :'(
Two days later and pharmacy was able to fill the dexamethasone and the Injector pack with two doses of Imitrex.
Unfortunately they did not have the refill Imitrex packs in yet and I got to hold my breath for another 24 hours.
Luckily for me, the dexamethasone started to work quicker than we expected.

As I continue first guided trip through Cluster Hell armed with a map & paddle, I thought that I would update this post for others to reference.
Being new to the Imitrex & dexamethasone, I am like most and figuring it out as I go.
Knowing when to use the Imitrex injector is nerve racking since I don't want to waste a dose, but also don't want to experience more torture than necessary.
This is complicated by the dexamethasone since it makes me feel as if I'm about to have an attack come on at any moment.

By feeling as if I have an attack ready to come on, I 'm describing that first dull ache behind your eye.
After which, I check the time and wait for the next wave which is typically in 5 minutes.
That first wave of undeniable pain is when I use the injector.

Hopefully the dexamethasone effects will evolve a bit and not leave me with this feeling of "Living on the Edge".
The anxiety of an eminent Cluster Headache is paralyzing.
If I know what to expect and know that the dexamethasone will keep the Demon at bay, I think that I can move past it easy enough though.
Unfortunately, its too early to know what is to come.

First lesson learned...
Stock pile Imitrex & Alsuma!
The expiration dates on them can almost be disregarded as long as they are properly stored...
My neurologist comforted me by offering me access to his stock of Alsuma samples that he has on hand.
At $150 each, that makes the cost of my doctor visits much more palatable...  ;D   
After that, leave no refill unfilled!
I need to make it a priority item on the budget even when I'm not in the middle of a cycle.
An unforeseen upside to Alsuma being out of production though is that my insurance copay for Imitrex is $10 compared to $267 for the Alsuma.

I would also like to thank this community for being a priceless resource to me.
Being armed with the information that I needed has been a life saver.
I apologize for not being active on this forum when my CH is not active.
Like others, I have inadvertently associated the site with my condition.
For that, I am truly sorry, please forgive me...

Short update...

I got so lucky with the whole Alsuma thing.
My insurance covers all but $10 for the generic Imitrex, so that financial burden in gone!

The cortico steroid results are not clear to me yet.
They quickly effected the frequency and timing of my attacks but I'm not sure about how many have been prevented though.
By altering the frequency, I have not been able to predict & prepare as I normally would.
That combined with the longer "build up" time to an attack is quite strange...
My biggest concern at that moment is that they may extend my cycle in some way.

The Imitrex injections are such a wonderful relief.
Still working on when / how early I can inject in order to successfully abort an attack.
I've been having a fairly regular 1230AM attack and injected a bit early @ 1210AM after just the first hint of "The Beast" last night.
Slept though the night without incident, but had a 0630AM attack while shaving in the shower.
That had never happened before...
I was looking into the shave mirror in the shower and noticed the unmistakable "eye blow out" in less than 10 minutes.
(Almost no warning either...)

Oh well, the journey continues.
Today is day 7 and my cycle has been a traditional 10 - 14 days in the past.
Lots of new things happening in my first diagnosed / medicated cluster cycle ever!
I'll continue to update this thread unless I'm asked to cease...

Wonderful that you have received good relief so quickly and easily.

But a footnote warning: twice you have mentioned your anxiety about what's coming. Trying to predict the future is a hopeless task and only serves to keep your anxiety aroused. Take a look:

PAIN VS. SUFFERING

Please, reader, do not approach this little essay as an alternative treatment or cure for CH! Nothing outlined here is a substitute for good, sound medical care and treatment.

AT THE HEART OF THESE PARAGRAPHS is the recognition that pain and suffering are rather different experiences which can and must be changed by rather different responses. The pain of our CH is the subject of many of the messages we exchange, the topic fills the medical literature we read, and is the primary purpose for the multiple visits to doctors.

Suffering is quite a different animal. It is an emotional/psychological condition which is often experienced even when there is no pain; it is commonly experienced as fear, anxiety, depression, hopelessness, dread, and fearful anticipation.

Suffering is a normal, even automatic, response to pain, loss (as in death, divorce, or other major losses), and a host of other difficult experiences. However, suffering can be intensified, sustained, and even created quite independently of any of these experiences. In the case of our CH, suffering is too often experienced when we are not having attacks.

The hard paradox is: WE CAN SUFFER EVEN WHEN WE ARE NOT IN PAIN!  This is the paradox which we need to resolve if CH is not to be the controlling experience in life.

As you read our messages about CH they fall into two broad categories: causes, prevention, and treatment; and, the subjective experience or emotional side of CH. 

A sample of the "experience" messages which we see are along the lines such as:

"Ch is horrible; it never stops!" (Or it will never end; or they will go on all my life, etc.)
"I can't bear the pain!"

" Nothing makes me feel better!" (Or no medication works; all have failed and so on.)

"It's not FAIR!" (Or variations along the lines of, "why is God doing this?", "am I being punished?")

"I feel so GUILTY!" --because of how I burden my family or can't work, etc.

"The WORST thing in my life!" (Or some variation on how CH is a catastrophe that I can't handle.)

(Before moving on, you may recognize this concept as the core of cognitive therapy or Rational Emotive Therapy. These therapies are rooted in the basic idea that how we think about an experience creates corresponding emotional reactions--for good or bad. The research on the effectiveness of this approach is very good; outcome research shows that it is an effective form of therapy for depression, anxiety, and addictions of various types.)

Cognitive therapies teach people to recognize:

A. These thoughts may be spontaneous and automatic but,
B. They are not rational thoughts, and so, in their very lack of reason they,
C. Stimulate emotions which are disruptive, distorting, and which intensify the difficult experience of CH and,
D. This style of non-rational thinking and the associated emotions tend to spill out (generalize) into our larger lives affecting relationships, our beliefs in how effective we are, how well we are able to run our own lives, and so on.

IF (and this is often difficult to both see and to accept!) we can begin to see HOW our thinking may not be fully rational and HOW these ways of thinking feed our SUFFERING--then it may be possible to change our thinking habits.

The next step--past a willingness to consider that we may be thinking  this way--is to learn how to dispute with ourselves, that is, how to argue that our own thinking is not reasonable, that it is self-harming. Then we learn how to change these thinking habits (with the goal in mind that by changing how I think about my experience will change how I feel, how my emotions affect me.)

(Understand that this is an outline of a fairly involved process. I'm just trying to quickly summarize how this method of self-help works. Sources of material are at then end.) So, let's go back to the sampling of expressions which we see in our messages about CH and see how cognitive psychology would deal with them.

1. "CH is horrible; it never stops!" First, recognize the despair and hopelessness which arises from this statement: where will this line of thinking take me? So, we learn to respond more rationally, i.e., "Yes, it's hard pain--but it has always stopped even when I don't treat it. I can survive this attack as I have every other one. I need to do what I know helps."  The long term effective of this change in thinking is to increase self-confidence and a sense capacity to benefit ourselves.

2. "I can't bear the pain!" Response: "I always have. I know pretty much what to expect; I've got some medication which helps. I can bear the pain because I always have!"  Notice, this is not a denial of the pain; it's not a "let's pretend". The goal is to deal with the reality of temporary pain; pain which, as bad as it is, has always stopped with our return to reasonable well being. It is the denial of this, our personal experience, which arouses suffering and despair.

3. "It's not FAIR!", or thoughts of GUILT, or that I'm being PUNISHED. Response:  "This is my body not working right; it has nothing to do with morality or sin or fairness. My job is to care for ME, NOW, not fret about fairness." (The consequence of  an appeal to "fairness" is that we become victims. The problem with "guilt" is that we have to find a "sin" which justifies having CH or we must convince ourselves that we have chosen CH to avoid something or to hurt someone, hence, our sin. In the end, this line of thinking is not reasonable or rational and serves to create more suffering.)

4. "CH is the WORST thing in my life!" I often see folks express in their messages a sense of anticipation, of feared expectation about the next attack of cycle. There are few responses which lend themselves to the development of suffering better than this one: waiting for pain; looking for the next sign; assuming that it will come. Reflect a moment on what the impact is on our emotional well being and you may begin to appreciate why changing thinking habits is of value.  How to respond?  "It is the worst experience--when it's occurring--then it's over and I return to my full life. My whole experience says that I'll come through the next  one--when and if it comes. I don't have to wait and look for it; there is living to be done, now."

If you are interested in exploring this way of altering your thinking habits there are three readily available sources of information:

1. Go to Amazon.Com and put "rational emotive therapy" in the book search box.

2. Go to START PRINTPAGEMultimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or END PRINTPAGE and get the catalog. (This is the homebase for Dr. Albert Ellis, the founder of Rational Emotive Behavior Therapy.)

3. Look for a paperback, FEELING GOOD: THE NEW MOOD THERAPY, David Burns, M.D. While this title is written around the issue of depression, the general framework can be applied to coping with cluster headache.
  This is true for many of the titles you will find at #2; REBT and  Dr. Burns' cognitive restructuring approaches have been used for a wide variety of problems--the general framework is fairly universal, in this sense.