Went to the Jefferson Headache Center in Philadelphia yesterday. Thorough review for about 5 hours (including some psychological eval). The bottom line is that the Occipital nerve block appears to be working and that will be the treatment of choice, with some drug combos (Verap and Topa) as a secondary treatment, if needed, and 10 day oral steroid as a backup.
So, it's been 2 weeks since the nerve block and no headache. Down to 100mg Topamax, going to 75 mg tonight and will be off in 3 weeks.
Perhaps this will be the answer I've been looking for.
After 16 months of pain, I can't describe the way I feel not having pain, especially since I'm now on 100mg Topamax and not dopey all the time.
It's really quite amazing.
Mike

I hope it is the magic bullet for you but also good to see that you've fall back measures in place in case it doens't too.