I've had clusters for about 25 years now.  I can usually control them with verapamil, lithium and imitrex inj.  Have an unrelated problem with my esophagus right now & can't swallow pills....they get stuck.  Looks like it will be at least a few weeks before that will be resolved.  Was already in a cycle when this issue started.  Had just upped verapamil & added the lithium.  The only way I can take them now is to crush them into a powder & swallow them that way.  I talked to the pharmacist about making them into a liquid.  Problem is that these are in the long lasting form & liquifying will change the chemistry.  Seems like crushing them is already doing that because I'm getting hit 2-3 times a day...I'm doing 720 mg verapamil, 900 mg lithium.  Imitrex works, but hate to use so much of it.  Oxygen does not work for me.  Doc wants me to start on Topamax, but I don't really want to start a new regimen in the middle of this mess.  I just emailed her to ask for a prednisone taper.  Can I crush that?  Any suggestions would be GREATLY appreciated.

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Oxygen does not work for me.

Can you describe in more detail how you've come to that conclusion? What source (concentrator vs. tank), rates (liters per minute), and method of delivery (type of mask or mouthpiece)?

Tank, non-rebreather mask.  Can't remember the rate, but had it all the way up.  Last time I tried was a couple years ago.  Just did nothing for me, and I tried it more than once. 

Hi K,

There actually is a small percentage of folks for whom even high flow O2 doesn't work, and I realize you could be one of them, but if you haven't tried going up to 25 LPM, 45 LPM, or even 60 (any of which requires a special regulator), it really would be worth a try IMO. I know that when I'm in high cycle I have to hyperventilate the 100% O2 at 45 - 60 LPM or it won't do jack.

Also, the demand valve system for O2 is sort of just assumed to be too expensive in the oxygen info here, even not recommended to start with, and details aren't given, but I'm starting to question that. If you could afford one, the fortunate users of them tend to report great success and fastest aborts, and if that isn't worth $300 to $800, what is?

Getting back to your original question: Over the years I've found this approach solves the problem..

1. Do not take too much water into your mouth. Seems reasonable that more would help get the pills down but I've found just the opposite to be true.
2. Take pills, hold them; take the water, hold it in your mouth.
3. Tip you head forward so that the water and pills are behind your front teeth; move your head so that the pills get well covered with water.
4. Now, be still for a couple of seconds; feel your throat muscles and relax them (takes a little practice but does become easy).
5. Gentle! flip of the head back so that the water carries the pills to your throat.
6. The hard part: don't swallow! Let the water do the work of getting the pills into motion back and down.

For me, the critical step is not rushing, letting the throat muscles relax. Trying to get over this whole process too quickly will tighten the throat muscles and block the passage of the pills.

Practice!

Thanks for all the replies.  I will think about the oxygen route again.  It just didn't seem to do anything for me & I ran out a tank pretty darn fast.  Also, I had trouble sitting for more than a few seconds when I'm getting blasted with a headache.  I can't seem to sit still during one. 

The issue I have with swallowing pills is a little more complicated.  It's not that I can't swallow, I have a narrowing or a small obstruction lower down in my esophagus (around the middle of my chest).  The pills catch there and don't go down.  I have an appointment to get scoped in mid-August.  I can eat food, and it usually doesn't get stuck, sometimes it does.  I talked to my neuro yesterday.  She has called in liquid Verapamil and liquid Lithium & gave me dosing instructions on those.  I will pick that up shortly.  I have also started on the vitamin regimen 3 days ago and hoping that will help.  So far, I haven't noticed any change.  I'm getting hit about every 6 hours.  Yesterday, one of the hits was only about a 4, compared to the 8's I've been getting.  One milder at midnight last night, then followed by another 8 at about 2am.  I have one right now that's about a 4.  Trying to hold off on the imitrex to see if they're actually easing up or not.

One question on the vitamin therapy.  Should you take all of it at the same time?  I've been taking the fish oil (liquid) at night and the D3 (liquid) and calcium (emptying the capsules into liquid) during the day.  Man, this cycle really sucks.

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Also, I had trouble sitting for more than a few seconds when I'm getting blasted with a headache.  I can't seem to sit still during one.

Do what the rest of us do: Get a 50-foot hose and dance to your heart's content!

I use yogert to swallow my pills... even the huge fish oil and calcium pills slide right down... then drink water after you get them all down.

Just an idea
Be Well
Linda