Immediate reaction: if Pred. didn't stop your attacks within 2-days either, 1. dose too small, or 2. possibility that you don't have Cluster.

Then, would like to know about your doc's experience, training treating headche disorders. A striking % of neurologists do no have training or experience treating headache.

For your own benefit, need to ask him--directlly--what is his training and experience WITH headache (other stuff he maly treat donesn't count in counting up the score!)

If his skills are not clear, consider seeking a specialist.
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LOCATING HEADACHE SPECIALIST

1. Yellow Pages phone book: look for "Headache Clinics" in the M.D. section and look under "neurologist" where some docs will list speciality areas of practice.

2.  Call your hospital/medical center. They often have an office to assist in finding a physician. You may have to ask for the social worker/patient advocate.

3. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or ; On-line screen to find a physician.

4. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or Look for "Physician Finder" search box. They will send a list of M.D.s for your state.I suggest using this source for several reasons: first, we have read several messages from people who, even seeing neurologists, are unhappy with the quality of care and ATTITUDES they have encountered; second, the clinical director of the Jefferson (Philadelphia) Headache Clinic said, in late 1999, that upwards of 40%+ of U.S. doctors have poor training in treating headache and/or hold attitudes about headache ("hysterical female disorder") which block them from sympathetic and effective work with the patient; third, it's necessary to find a doctor who has experience, skill, and a set of attitudes which give hope of success. This is the best method I know of to find such a physician.

5. Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or NEW certification program for "Headache Medicine" by the United Council for Neurologic Subspecialties, an independent, non-profit, professional medical organization.
        Since this is a new program, the initial listing is limited and so it should be checked each time you have an interest in locating a headache doctor.
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Stat to learn about Cluster. It will help you grasp whether the doc is on target in his treatment.
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Cluster headache.
From: Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or (Orphanet Journal of Rare Diseases)
[Easy to read; one of the better overview articles I've seen. Suggest printing the full length article--link, line above--if you are serious about keeping a good medical library on the subject.]

Leroux E, Ducros A.

ABSTRACT: Cluster headache (CH) is a primary headache disease characterized by recurrent short-lasting attacks (15 to 180 minutes) of excruciating unilateral periorbital pain accompanied by ipsilateral autonomic signs (lacrimation, nasal congestion, ptosis, miosis, lid edema, redness of the eye). It affects young adults, predominantly males. Prevalence is estimated at 0.5-1.0/1,000. CH has a circannual and circadian periodicity, attacks being clustered (hence the name) in bouts that can occur during specific months of the year. ALCOHOL IS THE ONLY DIETARY TRIGGER OF CH, STRONG ODORS (MAINLY SOLVENTS AND CIGARETTE SMOKE) AND NAPPING MAY ALSO TRIGGER CH ATTACKS. During bouts, attacks may happen at precise hours, especially during the night. During the attacks, patients tend to be restless. CH may be episodic or chronic, depending on the presence of remission periods. CH IS ASSOCIATED WITH TRIGEMINOVASCULAR ACTIVATION AND NEUROENDOCRINE AND VEGETATIVE DISTURBANCES, HOWEVER, THE PRECISE CAUSATIVE MECHANISMS REMAIN UNKNOWN. Involvement of the hypothalamus (a structure regulating endocrine function and sleep-wake rhythms) has been confirmed, explaining, at least in part, the cyclic aspects of CH. The disease is familial in about 10% of cases. Genetic factors play a role in CH susceptibility, and a causative role has been suggested for the hypocretin receptor gene. Diagnosis is clinical. Differential diagnoses include other primary headache diseases such as migraine, paroxysmal hemicrania and SUNCT syndrome. At present, there is no curative treatment. There are efficient treatments to shorten the painful attacks (acute treatments) and to reduce the number of daily attacks (prophylactic treatments). Acute treatment is based on subcutaneous administration of sumatriptan and high-flow oxygen. Verapamil, lithium, methysergide, prednisone, greater occipital nerve blocks and topiramate may be used for prophylaxis. In refractory cases, deep-brain stimulation of the hypothalamus and greater occipital nerve stimulators have been tried in experimental settings.THE DISEASE COURSE OVER A LIFETIME IS UNPREDICTABLE. Some patients have only one period of attacks, while in others the disease evolves from episodic to chronic form.

PMID: 18651939 [PubMed]
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Three sites which are worth your attention: medical literature, films, plus the expected information
about CH.

Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or
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Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or Search under "cluster headache"
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Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or
  Full of articles, blogs, book: written by one of the best headache docs in the Chicago area.
  Worth exploring. The latest book is in e-book edition, $10; comprehensive and worth buying for
  a careful read.
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But, at this time, the most important step is to confirm, with a good doc, tha you have Cluster. If you don't, much time will be wasted.

HI Tugn,
Welcome, sorry you had to find us.Just a couple of things
you can try that might help you control the beast.
When you next see your doc ask him about Verapamil,
it's the prefered drug for treating CH's.Also Melatonin
has a good record to help you avoid those night attacks,
you can buy it over the counter from your local drug store.
have you noticed the Vitamin D3 Regime on this site, it has
an 80% success rate in aborting CH's.
Hoping these few tips will help you become pain free.

Good Luck, Hoppy.

Reinforces my concern about your doc's skills. Sorry!
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Pring the PDF file, below. Commonly used meds for Cluster with evaluations of effectiveness.

Pred usually starts at 60-80mg but you only need it for a few days so this high dose not, generally, a problem.

Would suggest Imitrex INJECTION as the most effective for Cluster. Generic version available.

Not much to add to the above. It's all good advice and I would second Bob's concern that your doc knows what he's doing. Perhaps he can be educated but you might be better off requesting a referral to a headache neuro who has experience with CHs. You asked how we did it. We all went through periods of time like you are describing until we found ways to cope with and manage the beast. The list of interventions is quite long and in all probability only some will work for you. The hope is though that some will do the trick, you just have to experiment to find which ones: a good and effective abort or three; a good preventative; and if needed, an effective prednisone or methylprednisone intermediate. Keep writing and let us know how you're getting on, even if it's only to fuss. We know about fussing. God bless, and prayers your way! lance

Since they didn't give you the right mask, I'd suggest you get the one from the CH store - Multimedia File Viewing and Clickable Links are available for Registered Members only!!  You need to or .

I've got two of the previous version which are just great for using oxygen to abort CHs, much better than the cheap disposable ones with a small bag that most medical stores supply.

I got my oxygen on thursday but I don't have the right mask either gotta order one.  If your headaches just started at 47 I wish I was that lucky.  I mean it sucks to have them period as they straight up ruin your life which you've probably realized very quickly.  I been getting them since 18 and its hurt everything in my life for the last 10 years.  I hope that your lucky and whatever meds you take work great for you.  No one should have to deal with this type of crap in there life its just to ridiculous.  Oh and mark down when they started this year so you can prep for next year if they come back.  Mine always come the week of July 4th or a week after.