Welcome to the board Paul.
Some episodics go chronic, some chronics go episodic, no real studies or information on why it happens.
You should consider getting to a headache specialist neuro.You're probably catching on by now that not only do they not go away, they can get worse. Using coffee and ice as your only treatments is just not taking advantage of what's out there now. It's time to get a little more proactive in your treatment, develop an organized approach to managing them so they don’t manage your life. I use a 3 pronged approach, many use a similar approach:
1: A good prevent med. A med I take daily, while on cycle, to reduce the number and intensity of my attacks. I use lithium, it blocks 60-70% of my attack. Verapamil is the most common first line prevent, topomax also has a loyal following. Some have to combine lithium and verapamil together to get relief.
2: A transitional med. Most prevents will take up to 2 weeks to become effective. I go on a prednisone taper, from 80 mg to zero over a two week period to give me a break while my prevent builds up. Prednisone will provide up to 100% relief for many CH’ers but is harsh on the system and should only be used for short periods of time.
3: An abortive therapy, the attack starts, now what? Oxygen should be your first line abortive. Breathing pure 02 will abort an attack for me in less then 10 minutes, that’s completely pain free. Read this link as it must be used correctly or it will not work
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When I first started 02 therapy I had the same problem you did with rapid re-attacks. For many years I was taking an oral cafergot when I started the 02. 02 would beat it down, cafergot would buy me up to 12 hours pain free. I now use an energy drink and it pretty much does the same thing. Seems to speed the abort and pushes the come backer attack way back, I use sugar free red bull.
Imitrex nasal spray and injectables are very effective abortives. I use the injectables, they’re expensive, and I rarely use them, mostly just when I get caught away from the oxygen. The pill form generally works too slow to be effective for CH’ers.
Go to the medications section of this board and read the post "123 pain free days and i think I know why." It’s a vitamin/mineral/fish oil supplement, all over the counter stuff, that’s providing a lot of relief for people who have tried it, it’s a long read, worth the time.
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For now, get some energy drinks. Rock Star, Monster, any containing the combo of caffeine and taurine, chug it down as fast as you can when you feel an attack starting. Many can abort or at least really reduce an attack using these.
Finally, visit our sister board for “alternative” treatment methods outside of mainstream medicine. As you’ll see from all the success stories on this board, there is something to it.
clusterbusters.com
Read everything you can on this board, if you are a CH’er, knowledge is your best ally. We’ll help you all we can.
Joe