Veterans Affairs-approved medical tech sends pulses of relief to veterans, others with migraines, severe headaches

“There were times when the pain from my migraine was so severe, I had to crawl across the dressing room floor.” –Actress Morgan Fairchild

“What makes it difficult is that people think you are having a regular headache. You just can’t explain a migraine to someone who doesn’t have them.” – NBA Hall of Famer Kareem Abdul Jabbar

For U.S. Navy veteran T.J. Minneci, it starts as spots before her eyes – floaters dancing in her field of vision. Then her vision blurs – things fall out of focus. Soon and inevitably, comes the flash of a bright white light and she is in migraine hell once again.

Minneci suffers from refractory migraines – the kind that persist and disable – and does not respond to typical treatments.

“I would almost always have a migraine,” Minneci explains. “For me it was not whether I had one, it was the level of how bad it was. I had ones that were really severe, and lasted for a couple of weeks.”

Minneci did not have headaches before her military service. She served in the Navy from 2009-2014, mostly on the aircraft carrier USS George Washington as a flight deck aircraft director.

“I was one of those people who didn’t even get headaches,” she said of her pre-service days. “But I ended up with quite a few concussions during active duty and each one was worse than the last.”

Her concussions came about mostly from falls.

“During a big sea,” she remembers of one fall in particular, “I fell down a very steep ladder well coming from the flight deck.”

“Sometimes certain factors can cause the migraines, like a night of poor sleep or if I stay up later than I should,” Minneci said. “I can almost guarantee it is going to happen if my neck hurts really bad.

“Sometimes visual distortions tell me that they are going to happen. Other times they come completely out of nowhere and I am completely incapacitated in the moment.”

Despite her post-service mental health challenges, Minneci made an impressive foray into higher education.

She earned a Bachelor’s in biological sciences, microbiology/biochemistry, and cellular/molecular biology from the University of Tennessee, Knoxville. She earned a master’s in molecular medicine from Liberty University.

Today, Minneci is an analytical chemist for BWXT, a contractor for the U.S. Navy.

“We see a lot of migraines and headaches among veterans. They are very common,” said Dr. Alan Towne, a neurologist who has been practicing for more than 25 years. Towne treats a large number of veterans.

Towne also served 20 years and nine months (1996-2014) in the Virginia Army National Guard where he was a division surgeon. He was deployed to Iraq twice and Afghanistan once.

“I am part of a group looking at headaches in the military and we find there is a significant increase in headaches even after leaving the theater of service,” he said. “They are typically characterized as pounding headaches and are associated with nausea, vomiting, light and sound sensibility. It makes it very difficult for these people to carry out the daily activities of life.”

The Department of Veterans Affairs (VA) reports that veterans are more likely to have migraines and severe headaches than the general population – in fact, migraines among veterans is about twice as high as it is for the general population.

Between 2008 and 2022, the VA reported a 122 percent increase in the number of veterans using VA medical centers for headache care.

Enter Theranica, an Israeli-based technology company with U.S. headquarters in Bridgewater. Theranica focuses on “neuromodulation therapies” which is the practice of manipulating nerve activities in the body to stimulate the brain to relieve painful conditions.

Theranica focuses on treating idiopathic pain – a type of pain to which there is no observable physical condition causing it. Migraines and related severe headaches fall into the category of idiopathic pain.

“With these patients, you can see the areas in the brain responsible for processing pain are actually more active,” said Alon Ironi, CEO and co-founder of Theranica. “But there is no structural damage or infection that would be the cause of the pain. The diseases are harder to treat because you don’t know the root causes of them.”

Theranic’s product to treat migraines is called Nerivio® REN (Remote Electrical Neuromodulation).

“Our mission,” said Ironi, “is to develop, test and verify therapies to handle the symptoms [of idiopathic pain].”

Nerivio looks much like a blood pressure cuff. The patient wears it on either arm and when activated (by a smartphone app), Nerivio electronically stimulates certain nerve fibers in the arm which travel to the brain.

These stimulated fibers cause the brain to release certain neurotransmitters which in turn reduce or end the pain.

“It is similar to what medicines do,” said Towne. “Nerivio activates the body’s natural and analgesic systems – something already in your body – so it is not introducing chemicals that your body does not already have. Using Nerivio means one less medicine these patients have to take.”

Nerivio received FDA approval in 2019 and the U.S. Department of Veterans Affairs (VA) approved it for use in 2021.

Ironi said that the VA had a much more open and positive approach to non-pharmaceutical treatments than most medical and health care systems.

“My hypothesis is that the opioid pandemic was bad overall, but much worse for veterans,” he said. “This made senior clinicians at the VA more open to solutions that had no side effects or risks of addiction.”

NOTE: A National Institute of Health (NIH) Study from 2020 reported veterans were heavily impacted by the opioid overdose crisis “with drug overdose mortality rate increasing by 53 percent from 2010-2019.

“When I first started in medicine in the 1980’s, treatment for migraines was very limited,” recalled Towne. “People were using a lot of narcotics and opioids. We knew they were not particularly effective for migraines. They did not target the specific mechanisms of migraines, they just dulled the senses, which usually meant you were not able to work, or they made you sleep.”

T.J. Minneci began using Nerivio more than two years ago. Before that, her experience with medications to treat her migraines tracked with what Towne described.

“I had some medications that would work to a certain level,” she said. “I had some that just didn’t do anything at all, and others where the side effects were so bad, I might as well have stuck with the migraine.

“There are other medications you can take but then your whole day is gone. You are pretty much incapacitated and with some of the medications, your next day is ruined even if your migraine is gone.”

Nerivio changed it all for Minneci.

She straps the treatment device to her right arm so she can utilize it during the day when needed. She said she wears it “a lot” – for instance when running errands or visiting her doctor’s office. She keeps a spare one at her office.

“It works for me more effectively than a lot of the other medicines I tried which is fabulous,” Minneci said. “I can put it on and rest or I can keep going. There are no side effects.”

Not only is Nerivio effective for her when she feels a migraine coming on, she uses it as a preventive measure against their onset.

“Prevention is important,” said Ironi. “Initially the Nerivio treatment was indicated for acute treatment or aborting migraines. Patients only used it when they felt symptoms coming on. In 2022, we developed the indication approved by the FDA to use Nerivio for prevention.”

Minneci uses Nerivio every day for the recommended 45-minute treatment cycle.

“I find that really comforting,” said Minneci about feeling the pulses run up her arm, “because I know it is going to work for me. I would say my relief starts as soon as the treatment starts. If I am feeling extra bad, they have a video you can watch or listen to. It talks you through how it is working. You can think about your pain melting away.”

“Use it every other day for 45 minutes as a preventative treatment,” recommended Towne. “There is no limit to how many times you can use it during the course of a month.”

Today, Minneci lives in Virginia with two supporting angels.

One is her husband Robert, to whom she has been married for five years.

“He is just incredibly supportive, and he will drop everything if I don’t feel good,” Minneci said of her husband.

Her other support angel comes in the shape of a 55-pound Staffordshire pit bull terrier named “Spooks.”

“We got him on Friday the 13th of October,” Minneci said, explaining the dog’s name. “She is alert. She will notice what is happening to me when I am not feeling well and she will push me toward the couch or the bed.

“Once she gets me to sit down, she will take her head and put it under my feet and flip my feet up to get me to lay down. Then she lays down with me and puts her head partially on my body because she wants me to stay.”

“To me,” said Ironi, “the most exciting thing to see and hear is the testimony of the patients – in this case veterans. Even after so many years, I still get emotional, and I still get excited from every single testimonial.”