Hey Nancy,

Welcome aboard.  I've spoken with many supporters in your shoes and what you are going through with your husband's cluster headaches is the toughest of times.  Hang in there...  The good news is the situation will improve once your husband finds the right combination of treatments to gain control over his cluster headaches.

Trying to hyperventilate with one of the disposable non-rebreathing oxygen masks equipped with a 1-liter reservoir bag at a flow rate of 15 liters/minute is impossible.  I've tried it many times to no avail.

You should have the 25 liter/minute regulator shortly if not already.  If you've not already ordered one, your husband is going to need one of the $27.50 O2PTIMASK™ kits with a 3-liter reservoir bag from the CH.com store at the left.

An oxygen regulator capable of 25 liters/minute flow rates and the 3-liter reservoir bag on the O2PTIMASK™ kit will help improve the effectiveness of oxygen therapy for your husband as it will easily support hyperventilation with 100% oxygen. 

The O2PTIMASK™ kit will also reduce the effort of breathing as it allows your husband to fill his lungs completely with each breath of oxygen without any restriction/resistance or needing to wait for the reservoir bag to fill.

Your husband needs to understand that oxygen therapy for cluster headaches is not a relaxed or passive act.  If he wants to stop the CH pain rapidly, he needs to breathe the 100% oxygen like a big dog that just got done chasing a car.  As long as your husband has normal cardiopulmonary functions, he should be able to use the following procedures and breathing techniques.

The best and most effective breathing technique involves breathing at forced vital capacity tidal volumes.

This entails a breathing procedure and technique where you stand to give the diaphragm a full range of motion, open your mouth and drop your jaw like saying the word "Haw" as you exhale and inhale.  Exhale forcibly and when it feels like your lungs are empty, do an abdominal crunch like you do during sit-ups.  Hold that abdominal and chest squeeze until you hear your exhaled breath make a wheezing sound for a couple seconds then inhale rapidly until the lungs are completely full then repeat. 

This procedure and breathing technique will squeeze out an additional half to full liter of breath each time you exhale, hence the term "Forced Vital Capacity."  As end tidal flow of breath leaving the lungs also contains the highest CO2 concentrations, using this breathing technique will pump CO2 out of your circulatory system through the lungs much faster than your body generates it through normal metabolism. 

Using this procedure and breathing technique with 100% oxygen is hard work and yes, your husband will get tired.  We all do when aborting cluster headaches at the higher oxygen flow rates. 

However, once your husband learns that he can make the pain go away very rapidly using this procedure and breathing technique, he will find this method of oxygen therapy well worth the effort. 

BTW, I can collapse the 3-liter reservoir bag on the O2PTIMASK™ kit very easily at a flow rate of 40 liters/minute and sustain this flow rate for the 5 to 6 minutes it takes to abort a high kip level cluster headache.  I can also collapse the reservoir bag at a flow rate of 60 liters/minute for up to 10 seconds before I get pooped out and need to slow down. 

The reason for using this procedure and breathing technique is simple once you understand that there are two parts to successful oxygen therapy when it's used to abort a cluster headache:

hyperoxia - elevating arterial oxygen saturation to 100% and hypocapnia - reducing arterial carbon dioxide (CO2) levels below normal.

This is accomplished by intentionally hyperventilating long enough to pump out enough CO2 to reach a condition called respiratory alkalosis.

You'll know when you've reached this condition when you start feeling the symptoms of paresthesia - a slight tingling or prickling sensation of the fingertips, lips, or back of the neck.  You may also experience a sensation of dizziness.  If you feel too dizzy lean against a wall and keep on huffing and puffing until the pain is gone.

I've used this procedure since 2005 to abort my cluster headachs and have yet to fall or pass out...

You and your husband can practice this procedure and technique breathing room air as a form of training to prepare for the next cluster headache.   Both of you should start feeling the symptoms of paresthesia after three to four complete breathing cycles.

Once your husband has felt and recognized the symptoms of paresthesia during this training session, he'll know how to adjust his respiration rate with 100% oxygen to maintain it.  This is the fastest way to abort a cluster headache with oxygen therapy.

That a few folks at Lincare have never heard of an oxygen regulator capable of 25 liters/minute is understandable.  However, saying we can't inhale 100% oxygen faster than 15 liters/minute is an old wives tale that is totally wrong and not true! 

15 liters/minute is the maximum flow rate presently listed in the available medical literature as an acute treatment for cluster headache.  That will soon change.  At least you've educated them and they now know regulators like this exist and are used during oxygen therapy for cluster headache.

I'm an old Navy fighter pilot and have over 3000 hours flying Navy fighters.  All of that flight time was spent breathing 100% oxygen from takeoff to landing on missions averaging 1.8 hours in duration with some extended missions lasting up to 7 hours.

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Yankee Air Pirate, USS Hancock, Tonkin Gulf - circa 1971

I can tell you first hand that I would routinely suck down 100% oxygen at flow rates in excess of 25 liters/minuet on every flight involving air combat maneuvering at high G-Forces.

Over 125,000 Navy and Marine Corps pilots flying fixed-wing tactical aircraft have been breathing 100% oxygen like this since 1941 and they still do it today. It's a mandatory requirement.

We all must pass an annual flight physical with PA and lateral chest X-rays to remain in a flight status and in all that time, there have been no reports of any adverse events from repeated exposure to breathing 100% oxygen at significantly higher flow rates than traditionally prescribed for cluster headache so breathing 100% oxygen at flow rates greater than 15 liters/minute is very safe! 

You could easily call this the largest retrospective study of it's kind on repeated exposure to breathing 100% oxygen.  I'm still here a 67 and in excellent health as proof.

We computed the oxygen consumed on several flights from the ship where we conducted Air Combat Maneuvering (Dog Fights) for at least 15 minutes out of the 1.8 hour flight by weighing the 5 liter LOX Dewar before and after each flight.  From the LOX consumed we computed an average oxygen flow rate of over 25 liters/minute so peak flow rates were easily in the 35 to 45 liter/minute range during the dog fights.

Good on you for having your husband try the vitamin D3.  10,000I.U. should be a sufficient therapeutic dose.  See the attached pdf file.

Taking 2,000mg. to 3,000mg. of the Omega 3 Fish Oil and a couple of the calcium citrate tablets formulated with vitamin D3, magnesium and zinc along with the vitamin D3 will help even more as a CH preventative.  Please let us know how this regimen is working for your husband one way or the other.

Check you PM for more information on the above method of oxygen therapy and the anti-inflammatory regimen above.

Take care,

V/R, Batch