O2 works for well over 70% of CH sufferers. It must be used properly with proper equipment. You must start the O2 at the first sign of pain, the longer you wait and the higher the pain level, the more chance it won't work.

What you described, the CH hit being around for a couple hrs is a sure thing for O2 failure. Also the mask is very important, a NON-REBREATHER with a bag on it, NOT nasal canula's or masks without a bag. Please read the "oxygen info" link below.

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

The Imitrex injections are something you will get better at. For me the little pain of an injection is nothing compared to a CH.

The info you need is here on this site but it takes your effort to obtain it. CH in most cases won't go away (it may give us breaks) so we must learn all we can about it. Expecting our Doctors to know, can in many cases prolong the proper treatments.

Wishing you the best with CH and your Law studies.

Don

I'm sorry the nerve block didn't work. It tends not to be very effective. Skyhawk has given you the best line to follow, especially the part about bringing a tank with you. I was caught yesterday without access to my E tank, and got hit with a whopper. I had to use a migranal spray to break the hit...it's a little more public usable than trex but takes longer. My E tanks are my traveling companions. Blessings. lance

So... I wasted my whole tank basically by not doing this for long enough or with the right mask... I will be buying one immediately.

Unfortunately.. I live in a city so... being very close to my tank is not much of any option. I have a mini one that I suppose I could put in a gym bag, but not every day...

General progress update
I have been on prednisone 10 day taper since thurs (I started it in the afternoon on thurs). I was pain free until last night, which means I was about 3 days Pf and the only time I have even been two days PF was right after the nerve block so that doesnt really count.

I am hoping last night's hit was the last one as the prednisone begins to take full effect.

I also wanted to throw out there that I tried Zomig becuase my doc says that zomig as a nasal works better than imitrex's nasal and it def works albeit slower than an injection...

thats all for now, trying to keep the ole head up

Josh - no reason not to carry the small tank in your gym bag. I have seen others carry in a little special back pack type sling. You want it near you because it's most effective the sooner you start using it. My husband only every had E Tanks but we don't leave home without it!

Pred. works, usually within 24-hrs, to stop a cycle cold. But, because of side effects of long term use, you taper off it in about 10-days while, AT THE SAME TIME, starting to take, e.g, Verapamil, a med which takes a few days to build up in our body before becoming fully effective. So Verap. is used for the duration of your cycle, regardless of length, for it reduces/stops the CH attacks. (There are a few folks who have a very unstable cycle who use Verap 100% of the time.)

This is a widely used protocol for Verap:

Headache. 2004 Nov;44(10):1013-8.   

Individualizing treatment with verapamil for cluster headache patients.

Blau JN, Engel HO.


    Background.-Verapamil is currently the best available prophylactic drug for patients experiencing cluster headaches (CHs). Published papers usually state 240 to 480 mg taken in three divided doses give good results, ranging from 50% to 80%; others mention higher doses-720, even 1200 mg per day. In clinical practice we found we needed to adapt dosage to individual's time of attacks, in particular giving higher doses before going to bed to suppress severe nocturnal episodes. A few only required 120 mg daily. We therefore evolved a scheme for steady and progressive drug increase until satisfactory control had been achieved. Objective.-To find the minimum dose of verapamil required to prevent episodic and chronic cluster headaches by supervising each individual and adjusting the dosage accordingly. Methods.-Consecutive patients with episodic or chronic CH (satisfying International Headache Society (IHS) criteria) were started on verapamil 40 mg in the morning, 80 mg early afternoon, and 80 mg before going to bed. Patients kept a diary of all attacks, recording times of onset, duration, and severity. They were advised, verbally and in writing, to add 40 mg verapamil on alternate days, depending on their attack timing: with nocturnal episodes the first increase was the evening dose and next the afternoon one; when attacks occurred on or soon after waking, we advised setting an alarm clock 2 hours before the usual waking time and then taking the medication. Patients were followed-up at weekly intervals until attacks were controlled. They were also reviewed when a cluster period had ended, and advised to continue on the same dose for a further 2 weeks before starting systematic reduction. Chronic cluster patients were reviewed as often as necessary. Results.-Seventy consecutive patients, 52 with episodic CH during cluster periods and 18 with chronic CH, were all treated with verapamil as above. Complete relief from headaches was obtained in 49 (94%) of 52 with episodic, and 10 (55%) of 18 with chronic CH; the majority needed 200 to 480 mg, but 9 in the episodic, and 3 in the chronic group, needed 520 to 960 mg for control. Ten, 2 in the episodic and 8 in the chronic group, with incomplete relief, required additional therapy-lithium, sumatriptan, or sodium valproate. One patient withdrew because verapamil made her too tired, another developed Stevens-Johnson syndrome, and the drug was withdrawn. Conclusions.-Providing the dosage for each individual is adequate, preventing CH with verapamil is highly effective, taken three (occasionally with higher doses, four) times a day. In the majority (94%) with episodic CH steady dose increase under supervision, totally suppressed attacks. However in the chronic variety only 55% were completely relieved, 69% men, but only 20% women. In both groups, for those with partial attack suppression, additional prophylactic drugs or acute treatment was necessary. (Headache 2004;44:1013-1018).

=======================================
SLOW-RELEASE VERAPAMIL

Dr. Sheftell applauded the protocol for verapamil used by Dr. Goadsby and colleagues, which entailed use of short-acting verapamil in increments of 80 mg. “This method was suggested by Lee Kudrow, MD, 20 years ago as an alternative to slow-release verapamil,” Dr. Sheftell noted.

“I would agree with using short-acting verapamil, rather than the sustained-release formulation, in cluster headache,” he said. “I prefer the short-acting formulation with regard to ability to titrate more accurately and safely. My clinical experience anecdotally demonstrates improved responses when patients are switched from sustained-release verapamil to short-acting verapamil.”

Dr. Goadsby agreed that his clinical experience was similar. “There are no well-controlled, placebo-controlled, dose-ranging studies to direct treatment. This is one of those areas where clinicians who treat cluster headache have to combine what modicum of evidence is available with their own clinical experience,” Dr. Sheftell commented.

Joshl924 wrote on Mar 28^th, 2011 at 8:52am:


You soon get used to it. I've a small cylinder that I keep in a small backpack along with a regulator, mask and a couple of cans of Red Bull. Once you've got used to how effective oxygen is, you'll not want to be too far away from it.