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G'mornin jle! Welcome to the community but sorry you needed to join us! So, as Chf said, high flow O2 is a clusterheads best friend (lifesaver).....most of us require a min of 15 lpm delivered via a non rebreather mask to abort a hit.....I use welding oxygen and routinely abort hits in 5 to 8 minutes! Since your current doc already has you on some supplements, look into the vitamin D3 anti Inflammatory regimen.....this regimen requires ALL of the co factors to work but it is very effective for roughly 80% of clusterheads.....most of the co factors can be sourced at wally world but you can save substantially by ordering online from "piping rock"....you can start the regimen immediately but you should have your doc do blood work to determine your D3 level....normal parameters are 30 to 120 ng/ml (Mine was 19.9) but after reaching 80 to 85 ng/ml many folks report complete remission or see a reduction in the frequency and severity of hits! Also, as Chf shared, we have a longtime member who is a neurologist and professor in Boston.....I've had the pleasure of meeting him several times and he is a tireless advocate for the Clusterhead community!! More than happy to get you hooked up with him if you'd like. Finally, I know several clusterheads in NY, MA, and NH who have meet n greets on a regular basis....nothing like meeting another person that "gets it" and fully understands what you're dealing with....and, if you can find a way, join us in Chicago in Sept for our annual conference....we'll probably top 200 attendees...we had 185 this past September including folks from India, Scotland, and Norway! Dallas Denny

It sounds like you have a lot of pieces and now you have to fit them together. The supplement thing is pretty straight forward. Just follow the combination Batch has worked out. I am sure it will evolve but the foundation is solid. For a person with clusters oxygen works to abort. Oxygen has to be used in the prescribed manner. That means a pre treatment hyperventalation, 10-15 LPM flow of 100% O2 using some sort of non rebreather set up and continuing inhalation for 10 minutes after abort. Using low flow )2, poor breathing technique or stopping too soon will not give you an optimal treatment and may leave you with a false impression of oxygen's usefulness. Steroids in proper dosage should break a cycle pattern in its tracks. The problem is keeping the beast at bay. Steroids need to be sustained at fairly high doses for a while and then tapered. Using a dose pack doesnt give you enough steroid long enough and tapers too fast. A dose pack may help once in a while but doesnt have enough horsepower to help manage a bad cycle. If your doctor refers to the suggestions in "UP-To-Date" (a physician reference) the info there is good and very mainstream. Do your best to stay organized in your treatments so you have a solid idea of what works. Sometimes when things are bad everything and the kitchen sink gets tried and you end up being confused about what works. Some very good core treatment options have been described on this site and those folks have put the info together in an understandable way. Review it, make yourself a plan and keep track. You will make your own situation much better. Good luck

I'm surprised you have a neuro with 12 CH patients. That's a lot. 2000mg of magnesium seems like a lot, too, but maybe that's based on his experience. I would say your list of items should be 1. OXYGEN (this is also #2 and #3) 4 and 5. Probably a tie between a preventive and Imitrex that works (preferably injections but maybe nasal spray would work). Verapamil is the most commonly prescribed preventive. It should be monitored for its effects on your heart and blood pressure. I think it is usually started at fairly low (and therefore fairly ineffective) dosages and raised depending on tolerance. You might start at 160-240mg/day, but it can take 900-plus mg/day to be effective in cycle. As Pebbles said, the standard 6mg Imitrex injector is more than anyone with CH needs. If your doc won't prescribe vials and syringes or 3mg injectors, you can disassemble the 6mg autoinjector and use 2mg per injection, or maybe 3. We can point you to how to do that if it comes to that. 6. Blood test for your vitamin D level. This is part of a basic blood panel. As Denny says, as you get your D levels up and use the whole D3 regimen, it can replace verapamil as your preventive. If you discuss the D3 regimen with your doctor, he might be troubled by the high amounts of D3 that it involves. Batch, who observes the D3 regimen closely, has seen no issues with D3 at these levels if it is properly taken as part of the whole regimen and D levels are consistently monitored. Right now, you are looking to get the basics in place. Don't ignore that energy shot suggestion. It can help with clearing shadows, too, and another thing that clears shadows for some people is ginger tea.

The injections will cause rebound headaches same as the pills. The injections will work much quicker than the pills though. If you use the injections try to get in vials with syringes or in 3mg auto injections. You can also learn about splitting the doses, most people can abort attacks with 2-3mg. I hold back as much as possible on injections and only use when I feel I can't get with 02. Work on oxygen therapy technique.

I take L-theamine 200mg, Mg-chelated and melatonin 10-20mg 1h before bed. It reduced my night attacks greatly.

How much vitamin D3 are you taking? Most CHers who prevent their CH with the anti-inflammatory regimen take 10,000 IU/day vitamin D3 as well as the vitamin D3 cofactors (magnesium, zinc, boron, vitamin A (retinol) and vitamin K2) suggested with this regimen. You'll also sleep better taking this much vitamin D3. If you're desperate for sleep, abort the first CH of the night with oxygen therapy then take 25 mg of Imitrex... That should buy you at least 4 to 6 hours of uninterrupted sleep. Take care, V/R, Batch

Blood pressure meds -- particularly calcium channel blockers such as verapamil -- are also used as CH preventives. For general prevention, you should be trying the D3 regimen: https://clusterbusters.org/forums/topic/1308-d3-regimen/ Of course, I'm sure you know not to use the strap to hold the mask on your face. Just hold it, so it falls off it you do fall asleep.

Melatonin at bedtime, starting at about 9mg and perhaps working up as needed, helps a lot of people. Some find that sleeping in a more upright position helps, such as in a recliner or even sitting up at a table with pillows under the head. Are you staying on the oxygen for some minutes, maybe 5-10 minutes, after you have aborted the attack? That can help prevent or delay subsequent attacks.