well my friend i will offer what i can.
first outside of meds is have you tried an energy drink like monster or red bull or rock star. chug one down just as you know a hit is coming. next ice packs help with me some like heat. it is a individual thing. next a must is get a flow valve that goes to at least 15 lpm 25 lpm is better  with a non-rebreather mask, these two things are crucial to effective abortive results. 

  triptans are kindof funny some have reduced effectiveness to imitrex as the beast changes (it always does). if it doesn't work  try another triptan like zomig dissengrating tablet or nasal spray. there are other triptans.also other abortive treatments go on on. like dhe injectionsbotox,lidocaine. etc etc.
yes we all can relate to judgement,isolation and repeated futile attempts to relieve  relentless attacks.
you are not alone, we understand.
others will weigh in so learn as much as you can and find a good doctor that actually helps you.

take care friend and keep us filled in.

Thanks for the replies.  CH are not my only health problems so here you go CH, Hyperlipidemia, Chronic rhinitis, Cervical Radiculopathy, high bloob pressure, abnormal thyroid functions,  and a mood disorder LOL.  I am sure that I missed some thing but you get the idea.  The list of meds I am on Verapamil 360mg, zolmitriptan 2.5mg tab, Imitrex auto injector, Tizanidine,Tramadol, Temazepam, Promethazine, Omeprazole, Nortriptyline, loratadine, citalopram, lisinopril and Alprazolam, I think that is it.  I have seen soo many doctors, neuros and the head pain clinic in Ann Arbor, MI.  So I dont know if anyone can help but it is nice too know I'm not alone.

Dangerous to use both Zomatrip. & Imitrex at the same time!

Are you satisfied with the doc who is treating your Cluster? If not, get back and we can offer some info on finding a  good doc.

Suggest you print out this whole article:

 
Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or (Orphanet Journal of Rare Diseases)
[Easy to read; one of the best overview articles I've seen. Suggest printing the full length article if you are serious about keeping a
good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]
========
Explore the Michigan site and print out the two meds lists. Use the treatments lists to discuss options with your doc.

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

Here is a link to read and print and take to your doctor.  It describes preventive, transitional, abortive and surgical treatments for CH. Written by one of the better headache docs in the U.S.  (2002)
================
Michigan Headache & Neurological Institute for another list of treatments and other articles:

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or


 

  Thanks again for the replies and the info, the list of meds is what I am currently taking and I forgot to add Valproic Acid.  I do know the issuse with taking different triptans.  It is'nt very often that I use the zomig but when Im stuck with the beast at a 10+kip and trex did'nt work I will take any thing and a heart attack would have to feel better than ch pain.  If some one told me crack would help I would start smokin.  Its been 2-3 years with the beast every day and I am beat, spent, tired with no end in site.
   I went out yesterday and bought some Kudzu, Skullcap and Ordered some RC seeds.  I hav'nt taken them yet kinda sacred it will interact with the pharmacy that I take, if anyone know the contriditions of these let me know.  I go back to Ann Arbor Nov 4 and I will ask them then but I really dont want to wait that long.  So thanks for the all your help,  and I hope everyone pfdn.  Phil

Welcome and I hope you can find some relief. 

If you haven't figured out already, get the o2 up to at least 15lpm...when it is more effective you may even find longer time between hits.

I'd also try looking for a dr that really works well with you and play around with preventatives until you find the right cocktail that controls your CH the best possible.

Good luck!

Lisa 

Thanks swimchica623,  I go to the pain clinic on the 18th and if they dont give me a regulator then I will find one on ebay or something.

  My doctors are some of the best but I've been chronic CH sufferer for awhile now, there's no boo hoo hear, and soon I will kick this beasts ass.  When I see the Dr. on the 18th I'm going try to get him to take me off most of my meds, because I'm on so many different drugs I can even tell what works any more(nothing works).  I was'nt chronic at first but the past few years every day, and every time I go to a Dr. they try to give me more drugs.  I think I just need too start over.  Verap. helped for a few years.

  Your right these problems sound worse the way I stated them, I wasnt trying to do that sorry.  I am new to this site but have done alot of research on CH and most of the issues I have are fairly common among CH sufferers.  Chornic rhinitis or swelling of the sinuses 90-100% of us with CH have this,  Cervical radiculopathy or a slipped disc in the neck witch for me comes from scolosis an s shaped spine, a mood disorder witch I think is funny because anyone with CH's  that has had a k7 or above in pubilic has a mood disorder .  Sorry I will try to use plain english from now on.  If I forgot any thing just ask I'll be happy to explain.
      The meds I take are all from one doctor,and as far as how often I take them, here we go I'll try my best on this one Verapamil 360mg once a day in the morning, lisinapril 20mg in a.m. for blood pressure, loratidine 10mg a.m. for allergies, Citalopram 40mg in a.m. antidepressant, Omeprazole ?mg in a.m. for acid reflux, Nortriptyline 100mg in p.m. as a preventive, Tizanidine 4mg in p.m. for muscle spasms, Temazepam 30mg in p.m. for sleep, Promethazine 25mg for nausea/vomitting I dont take this very often my CH's rarley make me vomit, Valproic Acid 250mg twice a day as a preventive, Tramadol 50mg is a non narcotic pain releiver I dont belive this is an opiate even though the chemical make is similar I take this for the pain in my joints and back but it does'nt help much so I dont take it very often and Alprazolam .5 mg as needed for nerves and anxiety this I take very rarely even though I always have one in my pocket,  some times it works if I start a CH in public I take one before I start to panic.  Let me know if I missed any.  Thanks every one for the questions and comments.
  Best pf wishes to all,   Phil

Hi there, Chuck.  Thanks for the great words for my dear hubby.  I really want to give you a great big hug.  Those are great words to live by.  I will try to help him live the Chuck way.

Thanks again

Jen

Hi Phil
Good words from chuck.

A brief review of the meds you list suggest that some of them do the same thing as the next one.
One thing about clusters for many of us is that the more meds the worse the hits. If I were you I would seriously question the use of so many with your doc or find a doc just a little more in tune with CH.
Maybe dump all the meds and work with even just one like Verapamil untill the correct dose is found.

I would bet the side effects you mention with imitrex are possibly aggravated by all the other meds you consume. Its a wonder you can get off the couch at times.

Not being a doctor nor knowing your underlying health issues, my advice isnt really worth the page its printed on, I would suggest a full and total detox and you just might find the CH frequency and severity will improve in just a few days, who knows the cycle chronic or not might just end. The biggest improvement could come in the way one views CH. and daily living.

On RC Seeds - If thats the path you choose its best to completely detox from all other medications regardless. Especially the triptans. The possibility of serotonin syndrome and other issue may arise when mixing these seemingly harmless medications. The likliehood of zero results is even bigger.

The CB treatments have improved a lot of lives and are certainly worthy of consideration. Its more than just crunching a few seeds or... , the preparation of your body (detox) should be done as well for optimal results and a life with no pain.

I totally agree with Chuck and MJ.

I would also add that you should research the meds before going to the doctor. Don't just "blindly" do what they say and add meds to the mix. Really -demand- them for help in dropping some or all of the meds off. Like Guiseppi here said, "It is up to YOU to educate yourself and then help your doctor plan your treatment. If you just sit down in front of your doctor and say "make me better" you are setting yourself up for a great deal of pain."

Here's a Wikipedia entry for Tramadol:

"Physical dependence and withdrawal

Tramadol is associated with the development of a physical dependence and a withdrawal syndrome.[19] Tramadol causes typical opiate withdrawal symptoms as well as atypical withdrawal symptoms including seizures. The atypical withdrawal effects are probably related to tramadols effect on serotonin and norepinephrin reuptake. Symptoms may include anxiety, anguish, pins and needles, sweating, and palpitations. It is recommended that patients physically dependent on pain killers take their medication regularly to prevent onset of withdrawal symptoms and when the time comes to discontinue their tramadol, to do so gradually over a period of time which will vary according to the individual patient and dose and length of time on the drug."

And about Temazepam, same source:

"Tolerance

Chronic or excessive use of temazepam may cause drug tolerance, which can develop rapidly,[18] so this drug is therefore not recommended for long-term use.[13][19] In 1979 the Institute of Medicine (USA) and the National Institute on Drug Abuse stated that most hypnotics lose their sleep-inducing properties after about 3 to 14 days.[20] In use longer than 1–2 weeks, tolerance will frequently develop towards the ability of temazepam to maintain sleep, so that the drug loses effectiveness.[21] Some studies have observed tolerance to temazepam after as little as one week's use.[22] Another study examined the short-term effects of the accumulation of temazepam over 7 days in elderly inpatients, and found that little tolerance developed during the accumulation of the drug.[23] Other studies examined the use of temazepam over six days and saw no evidence of tolerance.[24][25] A study in 11 young male subjects showed that significant tolerance occurs to temazepam's thermoregulatory effects and sleep inducing properties after 1 week of use of 30 mg temazepam. Body temperature is well correlated with the sleep inducing or insomnia promoting properties of drugs.[26] In one study the drug sensitivity of people who had used temazepam for 1–20 years was no different from that of controls.[27] In an additional study in which at least one of the authors is employed by multiple drug companies examined the efficacy of temazepam treatment on chronic insomnia over three months and saw no drug tolerance, with the authors even suggesting that the drug might become more effective over time.[28][29][30] The Journal of Clinical Sleep Medicine published a paper which had carried out a systematic review of the medical literature concerning insomnia medications and raised concerns about benzodiazepine receptor agonist drugs, the benzodiazepines and the Z-drugs that are used as hypnotics in humans. The review found that almost all trials of sleep disorders and drugs are sponsored by the pharmaceutical industry. It was found that the odds ratio for finding results favorable to industry in industry-sponsored trials was 3.6 times higher than non-industry-sponsored studies and that 24% of authors did not disclose being funded by the drug companies in their published paper when they were funded by the drug companies. The paper found that there is little research into hypnotics that is independent from the drug manufacturers.[31] Establishing continued efficacy beyond a few weeks can be complicated by the difficulty in distinguishing between the return of the original insomnia complaint and withdrawal or rebound related insomnia. Sleep EEG studies on hypnotic benzodiazepines show that tolerance tends to occur completely after one to four weeks with sleep EEG returning to pretreatment levels. The paper concluded that due to concerns about long term use both toxicity and tolerance and dependence as well as controversy over long term efficacy that wise prescribers should restrict benzodiazepines to a few weeks and avoid continuing prescriptions for months or years.[32]

Physical dependence

Temazepam like other benzodiazepine drugs can cause physical dependence and addiction. Withdrawal from temazepam or other benzodiazepines after regular use often leads to a benzodiazepine withdrawal syndrome, which resembles symptoms during alcohol and barbiturate withdrawal. The higher the dose and the longer the drug is taken for, the greater the risk of experiencing unpleasant withdrawal symptoms. Withdrawal symptoms can also occur from standard dosages and after short term use. Abrupt withdrawal from therapeutic doses of temazepam after long term use may result in a severe benzodiazepine withdrawal syndrome. Gradual and careful reduction of the dosage, preferably with a long-acting benzodiazepine with long half life active metabolites such as chlordiazepoxide or diazepam is recommended, to prevent severe withdrawal syndromes from developing. Other hypnotic benzodiazepines are not recommended. [33] There are rare reports in the medical literature of psychotic states developing after abrupt withdrawal from benzodiazepines, even from therapeutic doses.[34] Antipsychotics increase the severity of benzodiazepine withdrawal effects with an increase in the intensity and severity of convulsions.[35] Patients who were treated in the hospital with temazepam or nitrazepam have continued taking these after leaving the hospital. It was recommended that hypnotics in the hospital be limited to 5 nights use only, to avoid the development of withdrawal symptoms like insomnia.[36]"

I think both are something you should really drop, if at all possible.

Edited to add: Here are links to two excellent medical documents depicting most common CH meds:

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

and

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or

Read  them before going to the doc and then hand them over to him or her.

- Best regards and PFDAN,
Rosa