So, I was just wondering if anyone has tried Sprix nasal spray. My doctor just scripted me for it and I'm waiting for the pharmacy to get it in. It's ketorolac (Toradol), which they give me IV in the ER if I need to go, so maybe it'll help for the bad ones... I've heard it can be very effective for migraines, but have not read as much about its use for clusters. It can only be used twice a week, which is fine. Thanks in advance.

Well, he prescribed it specifically after clarifying that it's the same thing as what they need to give me intravenously in the ER to abort an attack, and considering neither O2 nor triptans really do much I've been sort of up a creek lately. (And yes, I tried everything on the O2 page, including the demand valve and all that good stuff.) Obviously a nasal spray is not quite the same as IV, but still.

I think the 5-day rule is only if you're using it daily (like you said, after surgery or something). I assume twice a week is sufficient time to give your body a rest from the stuff. The doctor I'm with is indeed a HA specialist, and I severely doubt he'd write me anything dangerous or give me unsafe directions. Now, that doesn't mean it's going to work, but that's what I'm feeling about 2x/week versus 5 days in a row. Also, he didn't say this specifically, but knows I know well enough that if I take a dose on Monday at 9AM and Thursday at 2, for argument's sake, the next "week" doesn't begin until the next Monday at 9, if that makes sense. It's also something I can double check with the pharmacist when I pick it up.

Added: The other thing I forgot to mention is, over the course of the last 2.5 years, my headaches have sort of "morphed" so-to speak, from being very cluster like in the beginning, to less-cluster-like for a little while (not long), and back to extremely cluster-like for the past year or so. CH is still the diagnosis I've been given and am being treated for, but usually when I land in the ER it's not only because it's a really severe attack that I can't get a handle on (duh) but also a very long one... like outside the usual cluster range. So even though doc and I have never really talked about this, it's possible that the ones that most often land me in the ER are not really a CH attack even though they feel pretty much the same as my usual attacks, which is why they're responding to something like a strong NSAID. I really don't know, I'm just pondering, and as I said, don't actually have any secondary HA diagnosis. All I know is the toradol/ketorolac works wonders in that situation, so it's probably at least worth a shot with the nasal spray if I get one I feel is going to send me to the hospital.