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      Find-out what you think is working and what is notInventory time (to do this effectively, you need another person to give you some objectivity, a girlfriend, wife, husband, etc).  It has to be someone you know.  Make sure they know what you are asking.  This is not easy.
      Make a list of what is working (I will break each one of these down, in second), Triggers, Meds, Sleep Regimen, Exercise Regimen, lifestyle quirks, CH patterns, what you eat and drink.
      Triggers: Find out what these are and write them down until they are as well-known as your first name.  My triggers are anxiety, stress, some foods with nitrites, and certain alcohols.
      Meds: anti-inflammatory, abortives, preventatives (You should have oxygen, hi-flo 10-14 liters per minutes with a rebreather mask). If your abortives are not working, recheck the directions to make sure.  I sometimes get things wrong, it could be something as simple as missing a detail.  Are your preventatives helping at all?  If not; maybe a dosage change is needed or another like medicine (check with your doctor asap).
      Sleep Regiment: You need to go to bed at a certain time and wake-up at a certain time (this is a good Sleep Regimen).  Varying your sleep by as much as a half-hour either way can some effect.  (Staying-up past Midnight is a not recommended as the level of sleep you get is severely degraded).  If you have a fitness tracker, write down the sleep you are getting (getting 5/3 hours deep/light respectively is great).  If you are not getting good sleep, talk to your doctor about sleep aids, muscle relaxants, and other items to help you sleep better (please take at least 10 – 16mg of Melatonin a night either chewable to the pills you swallow).  Melatonin will help with the sleep transition issues (R.E.M. to Deep and Light).
      Exercise Regimen:  Exercise has too many benefits to list them all here.  Some of those are: increasing endorphin production, analgesic effect, increasing blood flow, increasing oxygen uptake, psychological benefit, etc… (Before starting any exercise regimen, talk to your doctor and start slow)
      Lifestyle quirks:  This comes under the heading of things you do that may hurt you or help you.  This could be something as simple as wearing a seat belt or stressing over little things (my personal issue).  Taking an inventory of what you do that either helps you or hurts, can help.  You want to do things you like/love.  This increases you’re your overall well-being (how you feel about yourself).
      CH Patterns: If you have enough cluster headaches, you know your patterns.  You also know when your patterns change.  Patterns change during the Equinox (Fall and Spring) and during the Solstice (Winter and Summer).  For some people they change the most for the Equinox, others during the Solstice.  If you know your patterns, have the abortives ready in-case a cluster is triggered.  If you know your headaches are worse during a part of the year – prepare.  Talk to your doctor, tell them about your patterns, and tell them about which ones hit the hardest.  If your doctor (truly cares), they will listen and give you the advice you need and adjust your meds accordingly.  If they don’t – find another doctor, period (Finding a good doctor to help with clusters is the biggest challenge I know).
      What you eat and drink: I don’t want to tell you to eat hospital food (who would anyway).  But during certain times in your cluster cycle, drinking beer that has a lot of hops can be detrimental (I personally can have an IPA but something has a lot of hops, I can’t even take more than a mouthful).  Some people are not sensitive to any alcohol and other can’t have even a half-glass of wine.  You have to know what makes your CH worse.  Then stay away from that food or drink as it will cause you the worst pain.

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