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Published on October 14, 2020

When Migraines Won’t Go Away, Ask Why

It took a stroke before a sheriff’s deputy was able to make the heart-head connection.

Amanda Wellendorf remembers waking up to that throbbing, spinning, sickening feeling of a migraine. She has been having them since she was 17. “I thought I was having a really bad migraine. Any movement of my head had me spinning with dizziness,” she recalls. “I did what I usually do. I took migraine medicine and went back to bed.” Only this time it didn’t pass.Amanda and Mom

Waiting too long

Wellendorf’s dizziness and nausea only got worse. She called her mom who stayed the night. When Wellendorf woke, she couldn't lift her head without the room spinning. It took two people to get her into a car and take her to Cone Health MedCenter High Point.

No joke

One of the first things the emergency department team did was a CT scan, which found evidence of a stroke. The 34-year old remembers looking at the giver of the bad news and saying, “You are joking.” After all, Wellendorf was an avid weightlifter and stayed in shape to cope with the demands of her job as a sheriff’s deputy. But the stroke team at Moses Cone Hospital confirmed the bleak assessment. She had had a stroke—and brain damage. And doctors found something else Wellendorf thought was odd—there was a hole in her heart.

The head heart connection

It’s called a patent foramen ovale (PFO). Everyone is born with one, but they usually close during infancy. About 25% of the time, they don’t. And most of those people never know they have one. But a small percentage of people with the hole in the heart wall between two chambers have migraines and/or strokes. Recent studies have shown that in people under 60 years of age who have cryptogenic strokes—strokes where no definite cause can be found—closure of PFOs is beneficial.

An easy fix

Amanda Wallendorf“This is not a complicated procedure. It has some risks; however, patients can go home fairly soon—usually the next day,” says Dr. Pramod Sethi, MD, medical director, Cone Health Stroke Center. A catheter is threaded through the large blood vessels into the heart. The device is placed over the opening in the heart wall sealing it. “In a few months, heart tissue grows over the device making it permanent. We find the procedure very reliable and very safe,” adds Dr. Sethi. Fixing the hole was the easy part. Coping with what it had done would take months.

Passing the DUI test

“Simply nodding yes or no made me dizzy,” Wellendorf says. She had to spend four days in the hospital rehabilitation unit learning how to find her balance so she could walk again. While it wasn't funny at the time, Wellendorf chuckles at the memory of being told to walk a straight line and stand on one foot. “A lot of the tests we do for drunk drivers I did in rehab.”

Almost all the way back

Over a year later, Wellendorf says she is 95% back to normal. She has occasional dizziness but keeps her balance and is back to work. She has even returned to the gym. More importantly, she says she hasn't had a legitimate migraine since.

“As far as strokes go, I’m actually very lucky,” Wellendorf says. “I know I'll get back to 100%, but it'll take a while.”  As for the DUI tests and the other therapy she has been undergoing, “The PT people were tough on me, but they were awesome.”