Hi All,
I've been 'lurking' for awhile trying to get some information to help deal with the CH's.  I have tried many suggestions on the boards and today I have finally hit that frustration point where I am at a loss and very desparate. 

OK, my run down....
35 year old male.  Healthy.  Only medical 'problem' prior to headache problem was anxiety for which I take 200mg Zoloft and 2-3mg Xanax daily (for ~13 years).

So about 2 months ago I had a bad headache one afternoon.  The next morning I woke at 6:15am from a sound sleep with the stabbing left eye pain.  Went to doctor, he gave me Maxalt and Fioricet.  Next day...6:15am same thing.  Went to ER.  They gave me shot of imitrex (didn't help), shot of morphine (didn't help) then shot of Toridol 30mg (helped). CT scan fine.  Discharged with script for Percocet 5mg. Next day woke up 6:15am again, same story... Took 2 percocet which let me sleep for another hour...then back to the ER.  Another shot of Toridol.  Worked again. 

I followed up with GP and he gave me some Toridol pills to have around.  Can't take them for more than 5 days in a row. 

Next 5-6 weeks were ok.  Had a slight headache and took a couple of advil every day which worked fine.  Worried about a rebound but have a high pressure job and a wonderful 2 year old that I want to be pain free for. 

SOOO (sorry for rambling) about 2 weeks ago the stabbing headaches came back.  They were not as regular as they were before.  When they came back my neuro was out of office so I went to ER again for oxygen and Toridol 60mg.  Helped but not as much as last time.

Went to neuro...gave me Prednisone 50mg for 5 days.  Precocet 10mg.  Took the Percocets for 1.5 days.   Never again!! Worst pain ever.  Like I made the beast angry.  After 2 days of Prednisone I had my first truly PFD in months.  I was whistling and happy as a pig in slop! The next day the headaches were back.    I have controlled them a little with the toridol pills. 

Saw neuro on Friday after my brain MRI this week which was clean.  He gave me O2 script per ch.com's instructions, a script for sumavel dosepro (basically imitrex) and topomax for long-term.  Took my first shot yesterday afternoon.  Seemed to help a little.   By night time it was worse again though.  Woke up at 2am (~ hours after falling asleep) and pain was horrific.  Took a shot of imitrex and tried the O2. Provided very little relief but enough to fall back asleep for 1 hour.  Then back up again and did some O2. 

Now I've been up for the day since around 6am and I don't know what to do.  I've maxed out on the imitrex. The O2 doesnt seem to be working (fyi - M2 tank, 15 lpm with NRB mask) although I'll keep trying.

The back of my head and neck on the 'bad' side hurt a lot too.  Does this happen with anyone else? I dont know what to do today. It always seems worse on the weekends for some reason too (more sleep seems to be worse).

OK so for the kicker here....just found out the wife is preggos.  So happy but want to get pain free for her and the little guy ASAP.  I am desparate and truly sitting here not knowing what to do.  I could take a toridol pill but that's about it.

Thanks all! Your advice to others has carried me for the last 6-8 weeks.

Guyute, First of all, welcome. I've used toradol injections in the past. They only worked a little to abort, did not prevent. They are also limited to 2x/week. Not a good solution for me. My first neuro also started me on Topomax and lots of Vicadin/Percocet. The Topomax made me very loopy, dizzy, and didn't do much to slow down the CH hits. The Vicadin is a bad path, addictive and can cause what are called "rebound" headaches, actually perpetuating the cycle. Verapamil is definitely a much better path for CH (for most), as are Imitrex injections or inhaler. Other factors come into play, though, such as heart condition, etc. I'm one of the chronics on Verapamil and Lithium with Imitrex and O2 as abortives.

Pain in the back of the head, same side as ch, is fairly common. I get neck pain as well, but it's caused by the stress of the headaches. Worth getting checked out, though.

I'm curious if you've been properly diagnosed. Topomax is not the preferred preventative for CH. It's a good idea to see a headache specialist. Many neuros just aren't that familiar with CH since it's pretty rare.

Oh, one other thing... cluster hits are known to occur more when you relax than when your intensely focused or stressed. Go figure. Not great for vacations, weekends, sleeping, etc.

-Chris

Thanks again, all.  It was interesting to read about what Chris said about them coming on during relaxation as opposed to stress.  My wife and I have been trying like hell to figure out why I am so much worse on the weekend.  I suppose this is at least one theory.  She has promised to try and stress me out more. 

I haven't gotten the script for Topamax filled yet precisely bc I wanted to see what CH.com had to say first.  I am moderately happy with my neuro so far but I do believe others are correct when they say I need to find a CH or headache specialist.  I looked on the OUCH links for recommended doctors and there is one practice about 1.5 hours from my house.  Problem is they're not a self-referral practice so I'd have to ask my neuro to write a referral and then they call you if they 'take your case'.  The same situation applied to a prestigious teaching hospital nearby. Akward.

Re: the Lithium, any thoughts on the interaction for someone like me who is maxed out on Zoloft for 12+ years?

I am pushing on with the O2 and will be buying the suggested mask and possibly a regulator that goes higher than mine. 

Again, thanks to all.  I'm almost through my pity party/why me phase!