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An abortive that works once or twice, then nuthin'? Unfortunately that is a familiar scenario to me. Example: Back in olden times I tried the newly reported-as-effective jamming of hot pepper capsaicin cream up the nose on the affected side and it aborted a hit! That one time. Following that it was just all nose pepper fire, no relief. I'm also the type who has found during the first days of a cycle, all kinds of stuff like lower flow O2, breathing freezing cold air, vigorous exercise can abort an attack, but as the cycle ramps up, forget it.

I switched insurance last November (got married and joined my wife's plan!) and have had an awful time getting scheduled to see any type of doctor. I have some expired sumatriptan but historically the sumatriptan has given me a very bad reaction so I'm avoiding it as much as possible. Hoping to get some non-medical oxygen this weekend! Fingers crossed! And I finally have a doctor's appointment scheduled for early April. Hoping I can bust the cycle by then though!

When my CH started it was only 20 minute attacks and just a couple few hits per week. It has progressed to more of a classic full blown CH since. With grandma being diagnosed it def smells like CH or combo migraine ch. I hope you can get it figured out! Great forum you are on. GL!

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Wish I could give you a good answer to the "why" part, and I suppose it's possible that your caffeine use was somehow keeping them at bay, but I don't think anyone knows the practical "whys" of how CH begins. I also don't know what to say about the pattern of your attacks, which is indeed unusual. As you say, your symptoms sound CHy, for sure, although 10-20 minutes is on the short side for attacks (but again, not completely unheard of). Are the 10-20-minute attacks situations where you've been having some pain and then it ramps up and then drops down again, or are they more self-contained experiences that start and stop in the 10-20-minute period? Have you tried anything for treating them (you mention sumatriptan that you have for the migraines, but you don't say whether it's in pill form or injectable)? Since you're new to all this, you might take a look at this "overview" file: https://clusterbusters.org/forums/topic/6213-basic-non-busting-information/

And another update! I've had three more hits and tried the oxymetazoline nasal spray with other abortive techniques (caffeine, 5 hour energy, chugging ice water, ice pack on head, ginger, etc) and have not had much success. The hit is shorter than normal (2.5ish hours) but not less painful. Bummed, but I'll keep trying it in case it works again, lol.