Oh my goodness, so sorry to hear how missing a dose potentially tripped you up from what had been a fairly effective remedy for you. Your description of how Emgality had been providing you with relief- (to take the edge off the most severe attacks such that you still have migraine attacks but more manageable ones) is one we are hearing frequently with the CGRP drugs, of which Emgality is one.
A couple of thoughts:
1) If your doctor is willing, it certainly wouldn't hurt to double up your dose in August. Indeed, we frequently hear of community members being prescribed double doses of these injectable CGRPs (Emgality, Ajovy, and Aimovig) on an ongoing basis. I take two injections of Emgality every month as one was insufficient for me. Of course, this must be a decision made between you and your doctor- but it is an option.
2) You could be experiencing a particularly intense attack that would've broken through your prevention coverage even if you had taken that June dose. This can happen from time to time and leaves us scrambling for logic but sometimes it's just what happens. I say this especially as you mentioned that your prior length of attack was up to 14 days in length (awful!) and here you are at 12. So you're within the range of what has been normal for you.
3) Keep an eye on things. We've heard that these drugs can lessen or stop their efficacy. This can be a heartbreaking thing when you've found such relief in them. It's not the end of the road, however, as there are many versions of CGRPs, so if you begin to find that Emgality is less effective, you can shift to a different kind and hopefully find relief there. We hear this happens frequently.
4) You were right to toss the frozen dose. The literature does make it clear that these drugs should be kept carefully at the temp of the fridge and brought to room temperature only once prior to injection.
Hope this helps. We are certainly thinking of you and hoping you'll be experiencing some relief from this stubborn attack as soon as possible. Please let us know if you have any other questions in the meantime. We are here for you. Warmly- Holly -migraine.com team.