For Janet Hintz, 58, migraines had become a way of life, since her first one at the age of 14.
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,” says Janet, who has been a resident of Ravenna 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. The work produced stress, which led to stress headaches and migraines and considerable disruption in her 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 says. But still, the throbbing headaches came regularly, altering her mood.
“Quit making noise” and “Leave me alone” were things she often said to people around her because the headaches made her grouchy.
In October 2020, one of Janet’s headaches led to a major scare – but also, fortunately, to a turnaround 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. 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 a tele-health visit withDeborah Ewing-Wilson, DO, a neurologist and headache specialist with the University Hospitals Neurological Institute.
“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,”Dr. Ewing-Wilson says.
After a follow-up visit with Dr. Ewing-Wilson in December, Janet was prescribed a new medication, galcanezumab, which is sold under the brand name Emgality, and rimegepant, which is sold under the brand name Nurtec.
Galcanezumab is a monoclonal antibody that binds to the CGRP molecule and blocks its receptor. CGRP has been studied for its role in migraines, Dr. Ewing-Wilson says.
Similar medications are fremanezumab, sold under the brand name Ajovy, and erenumab, sold under the brand name Aimovig.
Rimegepant is preventive therapy – a CGRP antagonist that aborts acute migraine, Dr. Ewing-Wilson says.
“It is also being studied in prevention of migraines and preliminary data shows it to be effective," Dr. Ewing-Wilson says. "The triptans, although they also are effective abortive medications, made Janet’s blood pressure increase to dangerous levels.
“Now is a good time for migraine sufferers because we have many effective options in our treatment armamentarium,” she says.
Janet administers galcanezumab with a shot to her leg every 30 days. Rimegepant, which is taken via a pill that dissolves in the mouth, 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,” Janet says. “It was truly like a miracle. In the first three months, I had three migraines instead of three or four a week. It was really life-changing.”
While life isn’t perfect for Janet, it is far better than it was. She is dealing with several other ailments, including a recent diagnosis of ankylosing spondylitis, but she regained a lot of her life without having to worry about unexpected, debilitating migraines.
Fewer migraines has allowed 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 mix – named Sparky, and visiting her brother and her friends – on Zoom for now – without getting grouchy from migraines.
