Hey Kristen,

Here's the latest oxygen therapy procedure and breathing technique you should try to abort your CH.  You'll need one of DJ's ClusterO2 kits from the CH.com store tab at the left of this screen.

I call this method Oxygen Therapy with Hyperventilation.   It essentially involves hyperventilating with room air at forced vital capacity tidal volumes for 30 seconds followed by inhaling a lung full of 100% oxygen and holding it for another 30 seconds.

Remove the face mask from the ClusterO2 kit when you receive it as you'll be breathing directly from the 22 mm nipple on the green "T" manifold or mouthpiece as shown below.  You'll also need to adjust the oxygen regulator so it fills the 3 liter reservoir bag completely in one minute...

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You'll also need to cup the T-manifold exhaust port in the palm of your hand and press the open breathing port to your cheek or chin when not inhaling from it to keep oxygen from escaping and let the reservoir bag fill while you're hyperventilating with room air.

Start by standing to give your diaphragm full range of movement... This is important as standing during this procedure helps ventilate the lungs more completely.  Lean against a wall if you get dizzy while using this method of oxygen therapy.  If you get too dizzy, sit erect in a chair.

The next step is exhale forcibly through your mouth until if feels like your lungs are empty...  they're not!  Do an abdominal crunch like doing sit-ups and hold the squeeze until your exhaled breath makes a wheezing sound for a couple seconds.

It sounds terrible but it's a very important part of this method of aborting a CH with oxygen...  This forced exhalation breathing technique will squeeze out another half to a full liter of exhaled breath.  This last volume or end tidal flow of exhaled breath has the highest CO2 concentration and blowing off CO2 is the key to the effectiveness of this procedure.

Then without delay, throw your head and shoulders back and inhale room air as rapidly and deeply as possible until you can't inhale any more.

Again without any delay, use the forced exhalation technique.  Keep repeating this sequence as fast as possible with room air for 30 seconds.  You should be able to complete 10 of these complete cycles in 30 seconds.

At the end of the 30 seconds breathing with this technique, exhale forcibly one more time and hold the squeeze for a good 5 seconds...  Then place the ClusterO2 kit "T" manifold breathing port to your lips and inhale a lung full of 100% oxygen as rapidly as possible and hold it for 30 seconds. 

I know it's difficult, but try to relax at this point.  While you're waiting, place the breathing port on the ClusterO2 kit to your cheek or chin with the palm of your hand over the exhalation port to form a gas tight seal in order to inflate the reservoir bag for the next breath of oxygen.

If you're doing this breathing technique properly, you'll start feeling the symptoms of transient paresthesia and a slight dizziness...  These temporary symptoms of paresthesia include a very slight tingling/prickling of the face, lips, and fingertips.  You'll also experience a slight rush when you start holding the lungful of oxygen...  Paresthesia is the best indication you've pushed your body into respiratory alkalosis.

At the end of the 30 seconds holding the lungful of oxygen, exhale into the room with a good chest squeeze... then repeat the above sequence until the pain is completely gone... 

Be sure to practice this procedure for a few cycles before the cluster beast attacks...

If you start this procedure at the first sign of an approaching CH attack, you should be able to abort the attack in four minutes or less...  and with as little as 16 to 20 liters of oxygen...

If the CH hits while sleeping and is well established or rising, start this procedure as fast as possible.  It will work effectively through pain level 9, (Kip 9), it will just take longer.

The following chart from the pilot study of the demand valve method of oxygen therapy for rapid CH aborts illustrates the increase in abort times as the pain level increases.

Oxygen therapy combined with hyperventilating on room air is just as fast at aborting a CH and as effective as the demand valve method.  I'm a patent holder of the demand valve method of oxygen therapy so I've studied and used it extensively since 2007.  It also uses a lot less oxygen so it works very well with low flow rate oxygen regulators.

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While you're waiting for the ClusterO2 kit to arrive and if you're handy with DIY projects, you can build a Redneck Oxygen Reservoir Bag Breathing System.  They work great...

All you need is a clean 40 gal trash bag, the oxygen tubing from your old disposable oxygen mask, an empty plastic Coke or Juice bottle (with cap), some Duck tape and some electricians tape.  The following graphics should help in this DIY effort.

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Fill the Redneck Reservoir Bag ahead of time.  If you've constructed it properly, it should hold oxygen for a few days.

When the next CH hits, turn on the oxygen supply and remove the bottle cap as you go through the first 30 seconds of hyperventilating with room air. 

Use the same breathing technique and procedures discussed above.  You'll be surprised at the lack of inhalation resistance sucking oxygen from the Redneck reservoir bag.

Take care and please keep me posted...

V/R, Batch