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It would be very inadvisable to self prescribe increased dosage of verapamil. Only a medical professional should be doing that as there are potential cardiac side effects to verapamil that need to be carefully monitored with ECG. Certainly your dose is too low, but it's important you work with a neurologist/doctor to increase it.

The only thing to request from your doctor is a prescription for oxygen. The standard prescription is something like: "Oxygen therapy: 15 mins at 15lpm with non-rebreather mask." The prescription then gets provided to an oxygen supply company, and that's where you need to put your attention to get the right equipment. In essence, that's cylinders (tanks) of O2, not a "concentrator" that makes O2 from room air; an M or H tank (the large types, for home use) and at least one E tank (portable for car, office, etc.); and a non-rebreather mask (NOT nasal cannula). If they'll give you a regulator that goes up to 25lpm (liters per minute), that will be nice, but most will just give you 15 lpm. You might read the "Oxygen" section of this document --https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/--which repeats what I said here and expands on it in some places. The big hurdle is getting that prescription. If there's someone you can talk to at the doctor's office in advance about the doctor's inclination or disinclination to prescribe O2, you might be able to provide information if needed to sway that decision. That info is in the file I linked to above. At the least, you might bring some of it with you.

....start with this and this...the first is the excellent O2 page from sister site clusterheadaches.com.....the second one of the many CHfather gifts to the family you may have already read.... Clusterheadaches.com NEW Message Board 10. - OXYGEN INFORMATION - ClusterBuster Files - ClusterBusters .....re verapamil...agree with drewbie...don't be changing dosage on your own. my neuro allowed me to titrate up and down, but only in increments after she trusted my judgement, and with appropriate monitoring. tripling your dosage is pretty dramatic... .....for me nothing less than 480 mg/dy worked (double that+ in high cycle) and sustained release instead of immediate release was worthless .....lotsa water and fiber to keep things moving as constipation can become an issue...

Wow.. thanks to you both! I’ve always read that Oxygen was an option, but NEVER had a chance to talk with anyone about its effectiveness - mainly because I NEVER talk to anyone about my CH.. it’s refreshing to come across an entire community of people who know exactly what I’m going through. The information, testimonies, and advice I’ve been reading through for the past few days has been PRICELESS. My Verapamil doses seem to extremely low compared to what I’ve seen here on the forum! (which is probably why it isn’t working) I’ve been taking ONE 120mg tab a day. Im going to try upping it to 3x a day. I still have not revisited the Immatrex injections, and have just been enduring the “hits” almost daily. The pain level for the past week or so has been about 6/10, so for some reason I keep telling myself that I’m on the final stages of this cycle so just ride it out. Any suggestions on how to request the Oxygen? E tanks, M tanks, masks, tubes, valves, regulators? I’m completely oblivious and this sounds like mechanic talk to me-lol!

Hi @LLL! I am VERY reluctant to contradict @spiny, who has been super knowledgeable and a huge help to me, and I don't even know if this is true: but the doctor / surgeon who performed my surgery said there was no MRI or test that could confirm damage to the peripheral nerves. He is extremely well regarded in Charleston (my city) for his expertise in this and other areas, but that doesn't mean Spiny could be right and he could be wrong. But in any case, he told me the best indicator was whether I responded to nerve blocks. If I did not, he would not have in good conscience recommended the surgery. Because I partially did, he said he felt good about performing the surgery. It was not until a week after the surgery, when I was there to have the stitches removed, that he gave me his findings. These were: both greater occipital nerves were badly compressed and damaged. (He described the specific damage but I won't go into that here, since that doesn't actually really matter much - whether they were damaged or not does.) He was happy: we made the right call. He continues to have followup appointments with me and we're both happy with the way things are going! Tiffany P.S. In the interest of full disclosure, I am also now undergoing the full Vitamin D protocol that has helped so many people on this forum, and also Vit M busting, for the same reason. These I started in earnest after the surgery to address the other symptoms I still had. The surgery was very effective in helping me eliminate, right away, the symptoms you described and it may yet be, as my nerves continue to heal (taking tons of Vitamin B to aid this along with the healing the Vit D provides), that the surgery plays a (big?) part in eliminating in those symptoms too. In studies I read, there were two people of very similar age, condition, and onset (concussion) to me, and this same surgery eliminated all their symptoms, but it took many months for one of them and over a year for the other. Their symptoms did reduce over these time periods, so I surmise it was just the healing process. The nerves were no longer compressed but had to heal from the beating they had been taking.

...hi DayLight...welcome! ....you've been down the road of standard CH treatment so it seems odd that OXYGEN wasn't already in there. was a game changer for me and many others, and is the primary abortive recognized by the medical field...absolutely life altering. i understand it's different for different countries, but any physician can prescribe O2 in the US...i got my first once i educated my primary, 20 yrs before i ever saw a neuro. if possible find a headache specialist....many neuros are as frightfully ignorant of CH and its treatment as most PCPs.... .....no need to repeat the the priceless info you will find in the CHf file above...just to commend its accuracy. i found my best OXYGEN sucess was in downing a high caffeine/taurine energy drink (2 oz 5-hr energy type, quick, easily downed, portable, no sugar), or EXTRA strength caffeine drink, at the first sign of a hit, while slamming the O2 mask on my face immediately following. had an E tank in the car, several in my office, and M's at home. there are various breathing techniques...most seem to find the best success by hyperventilation with intensive inhale and crunch exhale. i found slowww/deep breaths to be just as effective, with the added benefit of calming me the f down. breathe and hold another style. try 'em all, sometimes a combination of styles is the most effective... ....the D3 regimen is safe and easy and effective for many....good for you whether you are a clusterhead or not....you should start on it yesterday.... .....you are in a great place to learn about busting... best jonathan

Yes, yes, yes . . . OXYGEN. Any way you can get that sooner than waiting for your appointment (a physician you can call for a prescription)?? You could set up welding O2 pretty quickly. You should start the D3 regimen, too, but it's not likely to have an immediate effect. Busting -- sure. I would not abruptly stop verapamil without checking with a doctor. In fact, you might not be taking enough verap (some people need dosages in the 1000mg range for relief -- but you also can't go up very abruptly). Have you read this file? https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/ There are some things you can do to get through an attack better (energy shots and some specific strategies) -- listed toward the end under Other Treatments . . .

I hope this is still firm! Just bought non refundable tickets! @trjonas