Migraines started at age 44?!

TIA for help....around the same time as the quarantine began in the USA, I began to have headaches. My neurologist feels that they are migraines. MRI no contrast negative. Sleep study pending but I've had two in past ten years negative. But I'd never had HA before, and I'm 44. Went through complete surgical menopause years ago and on combined HRT but nothing has changed since then.

It's really scary, not just the pain, but what gets me is the "brain fog," or the cognitive effects. I work in a field I have to use my brain or someone can die, and my brain doesn't return for days! They are also NOT understanding about being absent. The migraine seems to respond to Nurdec some (stops pain and vomiting, but not the dizziness, crushing fatigue, and derpiness). The oral triptans don't do squat, plus many of them have lactose, which I'm allergic to. I'm seeing a second neuro next month to push for a spinal tap which the first wouldn't do - he kind of patted me on the head after a whole 3-min conversation and sent me home. The only other weird thing is my vision astigmatism in my R eye has worsened substantially and suddenly after 20 years of a stable measurement. And I *think* my son and I had covid-19 in Jan 2020, but we can't prove it. This all began in March 2020 but has been the worst this fall, gets worse every month. 🙁
I think my triggers, or the whatever it is, seems to happen a lot more after shopping in stores, wearing masks (nope - not trying to start a political or medical debate lol), or extreme stress. My husband says my hearing becomes sensitive like a bat and my speech gets slurred during these attacks, too. I get very dizzy and sensitive to light and sound and movement...but at the same time I get cravings to listen to 1980s "big hair" rock music, which seems to help some with the pain and nausea!
Did anyone else get migraines starting past age forty? Or anyone have any ideas what it could be? Sorry for the grammar, my brain isn't back from my attack two days ago.