Don't know if I'm doing this right!  The attached file is my CH history.  Have tried just about everything and am now on my 6th neurologist in 10 years.  The current regime was first Rx'd by neurologist #3 (no longer in practice) plus had to convince current Dr. to Rx oxygen (insurance won't pay for).  Read a lot and found your site many years ago, helped me get Rx for O2.

Insurance companies are not very informed about CH, but it's going to get Obama Better once Big Gov takes over?  Be very afraid of the future for CH sufferers!  I don't think Big Gov will care a lot about a MINORITY of people suffering with our condition.  Okay, no more politics!

Think this is enough for first post.  Someone let me know how I did??   Thanks,  Poppy
P.S. 17KB file would not attach will try and copy here:
Poppy
History:  Diagnosed 10+ years ago and for 8 years had active 6 to 8 month periods of CH’s with 4 to 6 months of remission.  CH’s usually started in September, October and would stop March, April.  Last two years there has not been a remission period for over 2 weeks.
Current Medication:  200mg Verapamil: Twice a day
500mg Depakote:  Once a day
Oxygen @ 12 ltr/min:  As needed, 5 to 15 minutes until pain subsides
40mg Relpax:  Every night that I want to sleep more than two hours at a time
Current Symptoms:  Ghost headache entire day, two or three days a week will take Goody Powder if pain starts to interfere with work.  Try to go to bed 9 to 10 o’clock (alarm set for 4:30am), two hours after falling asleep will wake with headache.  5 to 6 nights/month, if headache is minor (1 to 3), do nothing and hope it will not return, try to go back to sleep.  If pain persist, I use oxygen therapy and can usually go back to sleep.  6 to 10 nights second attack will occur, it’s now 3am, use oxygen to stop pain, make coffee, take Goody Powder and stay busy till it’s time to go to work.  Most nights pain is 4 to 7, use oxygen, take Relpax, go back to sleep and wake up when alarm goes off.  Since I can only get 18 Relpax/month will go weekends with just oxygen.  This usually means 2 to 3 attacks/per night, fairly tired the next day.  If I try to nap on the weekend, almost every time wake with (4-5) CH.  This has been my normal routine for two years with the only real remission being twice a year when I took prednisone for a month
So, I’m a 61 year old walking headache, Dr. doesn’t want to try lithium and I understand his reluctance.  Of the three (lithium, prednisone and Relpax) Relpax seems to have the least side effects, but don’t know about taking 18/month for the next 15-20 years?  Although I’m not showing any symptoms (complete yearly physical) family has history of heart problems.

200mg twice a day is on the lower end, but right up there for effective preventative levels. My therapeutic level was 480mg per day (taken 240mg twice per day). Worked better with 900mg of lithium per day, however.

Yeah I'd take prednisone every day too! Guarantees me almost 100% pain free time. But long term use can be really harsh on the body.

Like Brew, I use lithium. I'm episodic....which is funny because lithium has historically been more effective for chronics....I'm almost 50 and have had CH over 31 years. On cycle I do a 2 week prednisone taper while I ramp up on the lithium. Ideal dose for me is 1200 mg of lithium a day. I pee a lot the first 2 weeks until my body gets used to the lithium, I'm a little lethargic at first but nothing coffee doesn't overcome. At these levels we're no Hollywood zombies! I've been using lithium forever....20 years??? or so, and have had no ill effects yet.

Joe

Edited to add...at 1200 mg a day it blocks about 70% of my attacks and all but ends the night time attacks.

Poppy - I'm off lithium completely right now as it seems my cycle has come to an end. My cycles are all over the place, so I can't really tell you how long I'm on or off of it. I've been on it for as long as 3 years straight, and for me, combining it with verapamil really knocks the beast for a loop.

You do have to submit to regular blood tests while taking it as it can mess up your kidneys if you start taking what would be toxic levels. It's only through these tests that you and your doctor can determine what the therapeutic level is for you.

This combination - lithium and verapamil - has been an absolute life-saver for me over the years.

Thanks for the information I may need it to convince  Dr to give it a try.
Thought you might be interested in this:  Dr has Rx'd one week/month regime prednisone (30, 30, 20, 20, 20, 10, 10) with the following results: no CH's for five days, nights six & seven CH woke me up, but went back to sleep without any medication or O2.  CH's back after day 7 as usual.  Any comments regarding this regime?  7 days a month with no or minor CH, worth the risk associated with prednisone?  As stated before I would take prednisone all the time if it were possible, not only does it stop CH,s it makes almost all my other aches go away, and the euphoric usually kicks in on day 3.  The only minor (to me) setback is I seldom sleep more than 4-5 hours at a time, but naps are taken when possible.
Enough for this year, here's hoping for a rewarding 2010.