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Hi ifb, glad to see you got the super expert advice from CHf! sucking ice cubes (especially when placed on the CH side of the roof of the mouth) has worked for me as a helper for aborting attacks when I'm not in in a high raging phase of a cycle, but it's been an adjunct when also breathing freezing cold air at the very first sign of an attack. In warm weather this can be done by going out to the car (if you have one), blasting the A/C, sticking your shnozzola up the the vent, and doing some serious nose breathing. Then around the time a gloriously delightful in comparison ice cream type headache kicks in, the attack may just be aborted. And hey the ice cubes might even work in conjunction with the O2. I'm not familiar with Cambia, but if that's all ya got, one trick others have used with some success with oral versions of triptans - which take a while to kick in - is to take it right before sleep, if you get the typical wake up hit about one hour after falling asleep. A funny phenomenon some of us have experienced is we can throw back an energy shot (like the 5 hour brand) or drink (like Red Bull) to help abort a hit, then go right back to sleep. I'd say your doc was actually correct about the Zomig at the beginning, not during. You'll encounter numerous headbangers here who have knocked out entire cycles via the busting that CHf mentioned, and many who report good results with the D3 regimen.

Welcome, its'. As we say, sorry you have to be here. First things first. It will make a difference. Sounds like you had a useless system the last time. What is the current flow rate? It's rare for a doctor to prescribe more than 15 lpm, but most people find that flows higher than 15 lpm make for better aborts. Throw down some coffee or an energy shot as you start of the O2, use a good breathing technique, and your life is gonna start changing. Consider getting the mask that's made for people with CH: http://www.clusterheadaches.com/ccp8/index.php?app=ecom&ns=prodshow&ref=clustero2kit One way in which O2 is going to change things for you is that you won't need a triptan like Zomig nearly as often, because the O2 will stop the attack. Only an idiot would prescribe Cambia for CH and think it was sufficient. Only an idiot would take you off Zomig instead of cautioning you to use it less often. (Zomig is not a preventive. It doesn't prevent attacks. It stops (aborts) attacks that have begun.) Verapamil is a preventive, but 120 mg/day is useless. (Could be that they intended to increase it over time, but 120 mg/day is still a low starting place.) The ice cube to the roof of the mouth (or sucking ice water through a straw to the roof of the mouth) is something that has been recommended here. Glad it helps you. Drinking down an energy shot usually works better and easier, and O2 and a sensible abortive are also going to stop the pain, so very few people have to resort to the ice cube method. We're not giant fans of triptans or verapamil here, but they can have their place. The three things I would suggest you do are (1) Get your O2 going ASAP; (2) Start the Vitamin D3 regimen ASAP; (3) Read this file, which has info about (1) and (2) and maybe some other stuff that might be useful to you. https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/ And (4) Keep asking questions, and (5) Consider busting, at least as something to have in your back pocket for the future. (Busting discussed at the end of the file I just linked you to.)

Hello friends, The first 10 days of my indomethacin trial are behind me. I started to take it 10 days ago when a new barrage of attacks started. I was advised to take 150 mg/day when they started and continue for 14 days. When they started I took 100 mg and normally when they start, the intensity is ramping up one after the next and the background pain as well until it becomes unbearable and need Zomig to temporarily abort it or oxygen to make it livable. I can stand the entire thing without abortion for a maximum of 4 or 5 hours. I am usually on one 10 min attack every 30-60 min non-stop for around 3 days. Now with the indomethacin it was different. Started to feel an improvement already after an hour - attacks became bearable. Around the 6th attack it got worse again and I had to clench my teeth and bite myself through the pain but also this faded away. Next day I had a rather mild background pain the entire day and no attacks which never happened before. The next day in the morning, the attacks came back through but after the 3rd one it all suddenly stopped and the cycle was over. This was probably due to the long time between the last indocin pill in the evening and the first in the morning the next day. I feel that the indomethacin works for around 7 hours and then the pain creeps back through. All the days that followed were completely painfree except when there was more than 7 hours between two doses. Then the background pain came through again but was very fast erased with the next doses. This is also unusual as I have never had a single day completely painfree. So for me this is a very good result and that is definitely the best preventive I have used until now - comparable with prednisone. Abortive qualities are nearly similar to Zomig. However I do not consider the result definitive yet. I can still not believe indomethacin should work for me. I want to do another trial later in the year. I just came out of my 1,5 month remission and the headaches have not yet reach their maximum. If I have the same effects during August/September, then I will be convinced indomethacin is the solution. From a diagnostics perspective, I let it to the doctors to draw their conclusions. Can be they reclassify me as having paroxysmal hemicrania (CPH) instead of CH, which should be more in line with the symptoms I am showing. Have a nice day !

Hello friends, I usually take 2-3 days/week indomethacin to combat my CPH. Somewhere between 50 and 150 mg per day. With this regimen, I haven't had an attack since July (I then ended up in the ER because I skipped it) and it feels weird. Previous week, I started to believe it was really gone and was in for an experiment - no indocin this weekend... Well it didn't end well. Friday was OK but in the evening I felt something I recognized from in the past. Saturday morning 8 am attacks came in full force, 7-10 min per unit and after an hour I had already 3. Incredible pain like someone smashed a hammer in my eye. I then decided it was time to end my 'experiment' and took 100 mg indocin and bridged the time to get it working with an imitrex injection. Indocin stops my headaches but unfortunately it is not good for the gut. Pain in stomach and bowels is unbelievable and with a stomach protector, it does not make much of a difference. It's a matter of balance and always take the lowest possible doses. siegfried

....hi IFB...welcome....you've heard great stuff already...if i repeat, oh well... My GP has changed the scrip this time to 15L/min with a non-re-breather mask, which I believe is what you're suggesting i should use. .....some go (much) higher to find relief...don't limit yourself ...the script is just the "ticket to ride"...we each find the best flow that works...nobody else knows or cares what that is. a non-rebreather type is vital...just make sure you are not out running the bag....better yet would be a demand valve or direct from a tube. there are various breathing techniques.....most find hyper ventilating (strong inhale/stronger exhale w/a crunch at the end) the most successful.....others do breath and hold...or, in my case, sloooooooooow breathing (calms and decrease the adrenaline/anger/angst). w/o O2 i would not be writing this...saved my sanity and perhaps life. give it your best damn shot....most successful abort for the most clusterheads. it would be a real shame to suffer needlessly by giving up too soon... My Verapamil was increased last year to 240mg slow release. .....aint enough, that's actually a good STARTING point, the dosage most frequently reported successful is around is 480 mg/dy in divided doses. i went to 1040 in high cycle. immediate release thought to be more effective than slow release...do some research here for the nuances if you pursue. there can be consequential side effects so goal would be to avoid if possible .....tho good to know that clusterheads are more tolerant of these dosages than blood pressure patients... I was taking so much Zomig, that my benefit plan started capping it. Here in Ontario, Canada, the cost is $28 each spray. ...OXYGEN, plus energy drinks at first sign of a hit, plus Vit D3 regimen my best strategy...with Zomig NS (5 mg) as abort of last resort...and rarely needed.... but REALLY nice to have in reserve. in the US they start out with a cap...any more than 6 sprays/month is a raging battle to obtain...pricing similar for me... When I got below 3 boes (of 2). I would literally start to panic that I wouldn't be able to find more. ....STOCKPILE in between cycles...the stuff lasts a long time. best neuro i ever had knew this strategy...too many fights with insurance for her. tho oversuse of any triptan IS problematic...ya wanna get to the point where it's a rare need.... When I first started Cambia, it was very effective. Just like Zomig was at first, but I was told Zomig was to be used at the beginning, not DURING a CH. .....NSAIDS like Cambia rarely effective...tho many find helpful with shadows (Naproxen helped me there, nada for a full hit). danger is gastro issues (bleeding/inflammation/upset) with continual use/oversuse. if using a triptan, the vast majority find that immediately upon feeling a hit is critical...delay tempts fate... Maybe my GP didn't have a lot of experience in prescribing for Cluster Headaches, but I really don't think a lot of GP's have that experience. ...all too true....good reason for sites like this as we usually have to be our own advocates. except for a headache specialist, i knew more about CH than all 8 of my PCP's. my goal (successful or i left) was to find one willing to LEARN...and provide what i needed (mostly an O2 and triptan script)..... As for the energy drinks, is there a specific brand or certain product within a brand line? Or just plan old redbull ? .....buy by content (read label...and more detail available via google search)...nearly all have higher caffeine/taurine content than Red Bull (it's just the most known). i buy brand names at outlet stores for 50-75% off. look for minimum 120 mg caffeine/1000 mg taurine..... I am a little concerned that an energy drink in the middle of the night, I may not get back to sleep? ....clusterheads are different animals....i could down an energy drink and sleep w/no problem.....many report same... Mind you, the quality of sleep after a CH is pretty sh*tty. .....i was exhausted after a hit so no problem......O2 tank next to bed just in case a cycle with the 1 -hr wake ups...

Energy beverages (the 8 oz or larger drinks and the smaller "shots") work because they have a lot of caffeine in them. Some people credit other ingredients, such as taurine. I'm not persuaded about that. So straight strong coffee might work, as it does for some people. A 5-Hour Energy shot is very potent (about twice as much caffeine as a Red Bull, for example), and you can swill it down fast. Some people say the colder the better. Surprisingly, I'm going to say that 85-90 percent of people can get back to sleep quickly after taking it during the night. A non-rebreather mask is fine. Read the file I linked you to for advice about how to maximize its effectiveness. The other link I provided is to a different kind of mask made just for people with CH. Many people say it speeds up their aborts. (It's not technically a non-rebreather mask.) Just to be sure -- you are getting your O2 in cylinders/tanks, not from a concentrator, which is a machine that makes O2 from room air? Cylinders are much better than a concentrator. (Again, there's some advice in that linked-to file about being sure your O2 supplier gives you what you need--for example, at least one very big tank and one smaller one for portability.) 240 mg verapamil might somewhat reduce attacks for some people. It is still a low dose (as is discussed in that file I linked you to). I would say that to the extent that Zomig was making things worse for you, it was from overuse headaches, which are not really the same thing as rebound headaches. If you don't overuse it, it's probably not going to affect your attack rate or the severity of subsequent attacks. I am not a doctor, and there is lots of speculation about the possible "rebound" effects of triptans, but I think I am right about this. Again -- with a proper oxygen setup properly used (along with caffeine), and with effective preventives (I think most people here would prefer the D3 regimen over verapamil), you wouldn't be turning to the triptans nearly as much (if at all). Cambia is an NSAID. If it worked for you, that's great. NSAIDs typically don't work for CH, and I haven't seen any evidence that Cambia does, but maybe I missed it. Cambia is prescribed for migraine. It's relatively slow-acting, which is okay for migraines since they typically last much longer than a CH attack. My point about Zomig is that you said your doctor had prescribed it "as a preventative measure." I was just making the point that it doesn't prevent attacks (the way verapamil is supposed to, or the way the D3 regimen does), it only stops an attack that has started. So yes, you take it at the beginning of an attack. That doesn't mean that if you don't take it in the first couple of minutes it won't help you, so I'm not sure where the specific distinction would be between "the beginning" and "during." More effective at the beginning, but not completely ineffective during (depending, as you have said, on how far ramped-up "during" turns out to be).

So. I wrote that blurb at the office and I appear to have skipped over some things. My original scrip for O2 was 8-12L /min, as was prescribed by my neurologist. My GP has changed the scrip this time to 15L/min with a non-re-breather mask, which I believe is what you're suggesting i should use. My Verapamil was increased last year to 240mg slow release. I was taking so much Zomig, that my benefit plan started capping it. Here in Ontario, Canada, the cost is $28 each spray. When I got below 3 boes (of 2). I would literally start to panic that I wouldn't be able to find more. When I first started Cambia, it was very effective. Just like Zomig was at first, but I was told Zomig was to be used at the beginning, not DURING a CH. Maybe my GP didn't have a lot of experience in prescribing for Cluster Headaches, but I really don't think a lot of GP's have that experience. As for the energy drinks, is there a specific brand or certain product within a brand line? Or just plan old redbull ? I am a little concerned that an energy drink in the middle of the night, I may not get back to sleep? Mind you, the quality of sleep after a CH is pretty sh*tty.

https://journals.sagepub.com/doi/full/10.1177/0269881120940937 I hope this brings you the full text. The file is too large to upload

Back in 2016, a fellow wrote this: >>.I mix and chug down: 1 Teaspoon of baking soda 1 or 2Lime(s) (Preferably organic) 1 cup of filtered water (Don't use tap water) Not only I have been able to reduce the intensity of an attack, but I have been able to abort it. It's worked several times.<<

Thanks for attaching the two articles. Nice info to have here.