I was diagnosed with cluster headaches about 3 years ago now, and became chronic about a year ago. Since becoming chronic all of my medications have entirely stopped working. The best thing I have now is imitrex which is taking 40 minutes to an hour to work if at all and is causing severe side effects, such as heart issues, and severe vomiting which is exacerbating my already problematic ulcers. So I've begun looking into all the different types of surgeries and was hoping for advice on here. I understand all the surgeries are very risky. But am I right in that it seems like the gamma knife surgery seems to have the fewest risks in general? It seems like the main risk is the facial numbness and droopiness. I know the other way they cut the trigeminal nerve risks blindness though, does the gamma ray not risk that, or is there just less of a chance of it happening? I'm also aware that the surgery isn't a permanent thing, but as far as I could tell from the research I could get it still seems like the best option just because it has so many fewer risks than all of the other options.
And does anyone know a doctor who does these surgeries anywhere near Milwaukee, WI? And by near, I actually don't even care how close at this point for the most part. Chicago, Madison, or even if you know anyone in ohio or something. I'd be willing to drive a day or two. I'd like to sit down and talk to an actual doctor about my options, too. I just haven't had much luck in finding one.

Also, yes, I've been on oxygen. It worked absolutely great until I became chronic and now it hasn't done a thing since. I've also tried mushrooms but I have mental health issues and that's an even more dangerous option for me than the surgeries. I've also tried the water method listed on this website, and the vitamin regimen, and basically any otc methods of relief I could find along with the plethora of prescriptions I've been given over the past years.

So, if you have any current advice or opinions on any of the surgery methods you'd like to give, or maybe some type of treatment that isn't commonly listed here you think maybe I could've overlooked, I'd be happy to here it.
Thank you for all of your help.

I started at 15lpm which worked fine. When I became chronic my doctor tried putting me up to 25lpm and there was no change, so now I'm back to just trying the 15lpm whenever I attempt oxygen again. I have a non-rebreather mask, too. I considered getting the demand valve, but i thought at this point that woudn't make the difference between whether the oxygen was having any effect or not considering that it went from entirely getting rid of every headache to me not noticing it even slightly ever.

And I did try the RC seeds as well. They didn't do a thing for me at all.
Thanks.

I'm on the imitrex self injections. And yeah, I've got the proper O2 mask and everything. I was a huge hassle to my doctor when I first got my oxygen and made sure I got everything exactly as it said on this site.

So far, I've tried verapamil, topomax, and prednisone for preventatives.
For abortives I've tried imitrex in pills, injections, and nasal spray. Zomig nasal spray, maxalt, fioricet, prodrin, energy drinks with and without taurine, water, oxygen, lidocaine, cafergot, and a number of pain killers, mushrooms, rc seeds, vitamins, and melatonin.
I think there are a few more I'm forgetting, but I know I've tried most everything I could find on this site, other than a couple of the preventatives I know I've skipped.

O2 DID help. It helped for years. It stopped helping when I became chronic. I was episodic for a bit over two years. I became chronic a little over a year ago, and since then basically everything has stopped helping me. The O2 stopped working, the imitrex, the caffeine, the zomig, or topomax, or anything. And the Imitrex had been working within about 10-15 minutes back before I became chronic. Since then, it started causing a lot of side effects because I've been taking it more frequently and I've never handled it very well. I think the side effects are prolonging the cluster headache. So it's not necessarily that it isn't working, it's just working against itself at first but once those side effects go away some the cluster headache gets a chance to go away. But it's damaging my heart and my stomach too much to take it. The Maxalt and similar things never did anything for me either though. They never even touched my migraines let alone the clusters.

And I'm not willing to try smoking. Even being near smoke triggers a headache, so that just seems like a terrible idea for me. Plus I have severe allergies to smoke. Thank you for the suggestion, though. If I weren't so allergic I would definitely be trying that.

I've had SPG blocks, that's why I know the gamma ray surgery will probably be successful for a bit. But I have to get the SPG blocks about 3 times a week, and the closest doctor for me that does them is an hour drive away and isn't covered by my insurance, which I can't afford in the slightest.

What flow rate are you using?

         Potter

And again I ask what flow rate do you use.  It makes a big difference.

          Potter

Crank up the flow rate and huff like crazy.

       Potter

And... if you do not have this mask using 25lpm...
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you are using it wrong in my opinion. And we hyperventilate it, so small or not, if you can't express all of the air from your lungs, breathe in pure O2 as deeply as you can, then repeat quickly without the bag running dry, it is simply not enough.
And as for the busting... if you spend any time on that site you will see that results can be slow. You reported a drop in frequency and intensity after busting, but did you stick with it? It takes most people 3 to 5 busts 5 days apart to see real results. Some chronics have to do much more.

Edit: And when I say chronics (like yourself) have to do much more, I mean chronics bust in high doses 5 to 7 times, and have to follow up often, sometimes weeks, sometimes months. Most chronics have a hard to kill beast!