Hopefully this will be useful for anyone in New Zealand who is wanting to get oxygen to abort their cluster headaches (that should be enough words to help people using Google...)
First off, this process has been painfully slow, but I've finally got medical oxygen at home.
Your neurologist will want you to try preventatives first and then Maxalt Melt for an abortive. For me the preventatives work pretty well but the Maxalt gave me heart palpitations so I was left with no effective abortive other than Red Bull, which although it helps reduce the intensity and duration of the CH it isn't a silver bullet.
To start to get oxygen, you need to get a referral from your neurologist to the respiratory department for your local hospital. They will put this request on file and almost certainly put the request at a priority of 5, which means the request is rated so low that you will not even be on the waiting list. Instead you are essentially transferred back to your GP for care.
That process alone took me a couple of months. I was fairly patient during this, partly from verapamil doing a great job as a preventive and the CHs I was getting were pretty low Kip values.
I found out that my oxygen request effectively was not going anywhere the morning after a Kip 8 and that night I had a Kip 10 that had me in total agony for just under an hour. This was just too much for me to cope with knowing that oxygen wasn't going to happen.
The next morning I went to see my GP, getting the next available appointment 20 minutes later. I explained how I was at the limit of what I could cope with and asked what I could possibly do to abort the attacks. I gave the suggestion of banging my head against a wall until I knocked myself out. My GP was wonderful. She rang the on call respiratory consultant and got me admitted for a respiratory test as they want to make sure that oxygen really does work for my CHs. Luckily (it seems crazy to write that word) the beast arrived a few hours later and I got my chance to see what happens.
I couldn't believe how effective oxygen really is. What was starting as another Kip 9 or 10 was reduced to nothing in well under 10 minutes. And that was at only 10 litres/min and a re-breather mask (they were still looking for a non-rebreather one despite me saying it was needed).
I'd read about how wonderful oxygen was here, but I really must say that people don't say how utterly amazingly unbelievably wonderfully amazing it is. If I could add another 100 adjectives it wouldn't explain how much difference it made.
So having got as far as showing it works for me, oxygen can not be supplied for people with CHs under the oxygen home use criteria. But they can write a letter saying that oxygen has been shown to be effective and this can be used to obtain medical oxygen from a commercial supplier. You've to pay for it as it isn't available on prescription, but having experienced what it can do I'd pay for it with a kidney or my right arm.
Here in Auckland I was was told that BOC was the only supplier, their web site is Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

or

.
Before you can get oxygen cylinders you must get an account created, which normally takes at least 24 hours. However if you explain that it's urgent it can be done a LOT quicker, as I found out when I was able to get there 30 minutes before they closed on a Friday afternoon (Penrose, Auckland branch).
I've now got my oxygen, with a non-rebreather mask and a 25litre/min regulator.
I'm almost wanting the beast to come again, just so I can chase him away in a few minutes showing that his power over me has taken a HUGE step backwards.
Whilst at the hospital I did my best to educate some of the staff who seemed to be more than just clueless about CHs. One doctor insisted that CHs had nothing to do with the hypothalamus and were all caused by neck injuries. He didn't seem too impressed when I explained, in front of his students, that medical research didn't quite back him up on that, but he was too busy to listen more and was off to see his next patient.
However the best reaction was when talking to a nurse:
Quote:Oxygen is a drug, we really try hard to wean our patients off this as soon as we can
I didn't quite know what to say to this as the only people weaned off oxygen will be in the mortuary.
Anyway, back to oxygen and funding. The current criteria for funded home oxygen use is that the patient needs to have a severe breathing problem, so a "mere" headache does not qualify. My next step is to challenge this based not just on the scientific evidence but also on the economic benefit as oxygen is cheaper than maxalt / imitrix. But this might take a bit more time to get changed, in the mean time I'm more than happy to have oxygen.