New migraine med like a 'miracle' for 58 year-old Ravenna woman
Migraines were a painful way of life since the age of 14
For Janet Hintz, migraines had become a way of life, since her first one at the age of 14. Today she is 58 years old.
They would come without warning. Unlike many other migraine sufferers, she saw no auras, which are visual hallucinations that may come before the actual migraine hits, or other clues that one may be on the way.
“I first started getting migraines that were quite debilitating, my freshman year of high school,” said Janet, who is originally from Orlando, Fla., but has been living in Ohio six the age of 6, and has been a resident of Ravenna, Ohio for the past eight years. “I missed a lot of school from migraines that year.”
Even as she grew up, her migraines stayed with her, to the point where she was experiencing up to three a week.
She worked for 22 years in accounting, but the work also produced stress, which led to stress headaches and migraines, and considerable disruption in life.
She tried medications, from over-the-counter to prescriptions, but nothing was really effective, and the prescribed migraine drugs raised her blood pressure to an extremely high range.
She said her migraines could last four hours or longer, sometimes until the next day. Sleep was about the only thing that offered relief.
She also learned to recognize some of the triggers for her headaches, such as noise, chaos around her, and bright lights.
“Once you figure out the triggers, it helps you avoid them,” she said. But still, the throbbing headaches came regularly, altering her mood.
“Quit making noise” and “Leave me alone” were often things she uttered to people around her because the headaches led to a grouchy and unbearable mood.
One day, in October 2020, one of Janet's headaches led to a major scare, but then, fortunately, to a turn-around in her migraine nightmare.
As she tells it, “I was in my kitchen, putting away some meat. Suddenly my right side got numb. I thought I was having a stroke. My right leg got numb. My right arm acted weird. My face drooped. And I ended up in the emergency room at UH Portage.”
She managed to call 9-1-1 on her own. She said one of the paramedics said he actually had headaches like hers, but said he couldn't guarantee it wasn't a stroke. At UH Portage, they went through the stroke protocol with her. Scans – Magnetic Resonance Imaging (MRI) and Magnetic Resonance Angiography (MRA) – were negative for stroke or large vessel narrowing.
She was diagnosed with an atypical complex migraine.
The next day, Janet had an initial tele-health visit with Deborah Ewing-Wilson, DO, a neurologist and headache specialist in the University Hospitals Neurological Institute.
Dr. Ewing-Wilson said, “Her migraines progressed to the point where she suffered a complex migraine consisting of stroke-like symptoms which caused her to seek the help she needed.”
After a follow-up visit with Dr. Ewing-Wilson in December, Janet was prescribed a new medication, Emgality (which she takes once monthly), and Nurtec for preventive therapy.
Dr. Ewing-Wilson explained that Emgality (galcanezumab) is a monoclonal antibody that binds to the CGRP molecule and blocks its receptor. CGRP has been studied for its role in migraines, and Emgality is called an anti-CGRP medication. Similar medications are fremanezumab (Ajovy) and erenumab (Aimovig.)
Nurtec (rimegepant) is an oral CGRP antagonist that aborts the acute migraine. “It is also being studied in prevention of migraines and preliminary data shows it to be effective,” said Dr. Ewing-Wilson. “The triptans (also effective abortive medications) made Janet's blood pressure increase to dangerous levels.”
“It was truly like a miracle,” said Janet. “In the first three months, I had three migraines, instead of three or four a week. It was really life-changing.”
“Now is a good time for migraine sufferers because we have many effective options in our treatment armamentarium,” said the doctor.
Janet self-administers Emgality with a shot to her leg every 30 days. Nurtec, which is a melt-in-your-mouth pill, is for when she begins to feel the onset of a migraine. “So, the three migraines that I had, it stopped them within an hour,” said Janet.
So, while life isn't perfect for Janet, it is far better than it was. While she deals with several other ailments, including a recent diagnosis of ankylosing spondylitis, she regained a lot of her life without having to worry about unexpected, debilitating migraines.
It allows her to devote more of her life to things she enjoys, such as taking care of her husband Tom, a Navy veteran whom she married last year, and their “crazy” 16 month-old Chorkie (Chihuahua and Yorkie) named Sparky, and visiting with her brother and her friends (on Zoom for now), without getting grouchy from migraines.