Anyone get bad migraines that are debilitating and affect your ability to work? How did you approach this at your office, if at all? I am on medication that has helped immensely but I still occasionally get a bad migraine and I feel weird calling out sick using migraine as my excuse because most people don’t understand it. Any tips/advice?

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Oh god yes and whenever I say I puke due to my migraines, they automatically assume I'm lying and am just hung over. I saw a neurologist for botox and it helps greatly!

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I did treatments every 3 months per what’s instructed, so it was 4 treatments and then it stopped being effective.

I’ll give you non-medical advice since that’s what you’re asking for. I suffer from 8-10 migraines a month (up to 20 days a month in a bad month if you include headache/recovery days). I am former big law, now in-house and here is how I manage:

1. My bosses know I suffer from actual, serious migraines. I work odd hours so I can rest/nap when I’m incapacitated or can’t focus (one of my main/worst symptoms). Nobody cares as long as I keep them updated if I’m struggling to meet a deadline, which honestly doesn’t happen often since I keep it flexible. I usually don’t say anything and just take the time I need. I did this in big law too.

2. In keeping with the above, I listen to my body. There is absolutely no sense in sitting at my computer completely miserable and unable to work for hours at a time. I cut the screens, take a nap, and get back to it when I feel better. In the office I just nap at my desk.

3. I use distraction devices for when I’m fighting a migraine and need to keep working. A GOOD tens unit, back massager, heating pad/rice pack. I recently purchased a Nerivio device (prescription) and LOVE it as a distraction. A Cefaly device is next on my list (who doesn’t want to look like a robot!? 🤣).

4. When we return to the office I am going to have my lights dimmed. In my prior office I never used overhead fluorescent lights and always used soft, lamp lighting.

5. I prioritize sleep, as it is one of my biggest triggers. This is tough given the nature of the job, but it is always my #1 priority. If I don’t sleep, I won’t be able to perform. It’s that simple and 98% of the time I successfully guard it. Was I billing 2200 in big law? No. But did I keep up with my work to the point that it wasn’t a problem? Yes. If you have any known triggers, do whatever you have to do to avoid them.

6. I take rescue meds the SECOND I know I’m getting a migraine. This is hard for me given how many I get (I’m sure you’re all too familiar with the rebound headaches!), but I do it as much as possible. I’ve pulled out a pill in front of partners before and just given them a brief explanation. It’s not worth waiting even a half hour to do it in private and let the migraine take hold. Do what you have to do.

Feel free to DM me, even to just commiserate. It’s truly awful to suffer with migraines.

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Great advice! The only thing I have to add is that blue light glasses are a big help with fluorescent lighting too!

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Ugh, yes. Honestly, I get aura so I usually specify that those symptoms prevent me from working—it impairs my vision, I couldn’t work for that reason alone even if I could otherwise. As much as I hate that people have used “migraine” incorrectly to the point that no one takes it seriously, I probably wouldn’t be above making up that type of thing even if it didn’t apply.

(Also, if you haven’t tried adding magnesium for prevention, consider looking into it. I hate when people give unsolicited medical advice so forgive me for doing so, but I discovered it when I was absolutely miserable and desperate and it changed my life overnight in a way the prescription meds didn’t. It took me a long time to stumble across info about it so I try to spread the word.)

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Magnesium, riboflavin, and a b complex took a few months but have really helped me as well.

Guys I’ve tried literally everything medical wise for my migraines. I am on a preventative that works very well (I was getting 15-30 migraines a month), I’m really just asking how to handle this with my job.

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You’re not evil! Or if you are, we both are…😆
The lawyering skills have allowed me to twist into “just being positive and seeing the silver lining in the migraine struggle!” haha

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I highly recommend Botox injection for migraines. This has cut both the frequency and severity of my migraines substantially. I always keep a stash of both migraine and antinausea meds with me as well. They have fast acting quick dissolve versions and nasal spray versions now, which are pricier, but having a few for real emergencies is a good idea. Treating migraines early is key for me.. While I will never be completely migraine free, they don't control my life like they used to.

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I did Botox and it stopped working but thank you! I also use anti-nausea meds. I agree with you that I’m certainly glad they no longer control my life but I do get affected by them every once in a while.

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I was just talking about this with my mom and she recommended brain pep by nature’s balance! It’s an all natural capsule you can find at the vitamin shoppe and other online retailers

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Oh I have to look this up! Thanks

I’ve only told a couple people I work with, and people are understanding. I started taking triptans, which has helped a lot.

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It turned out mine were related to birth control! Cutting out hormonal BC more or less fixed them, but only after 10 years of problems and quite a bit of gaslighting.
I did not really approach it at the office because of rampant gaslighting/lack of boundaries in other aspects of my group’s culture. Best part was throwing up in the office and folks assuming pregnant or hungover.

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So interesting. The first doctor I talked to about my migraines tried to claim they were due to hormones and just wanted to put me on birth control. The migraines weren’t cyclical though, so I didn’t follow his advice. Glad I didn’t.

Following. I usually note that it affects my vision and cognitive ability

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I just say I’m sick and don’t specify what ailment I have.

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Yes I do that usually but sometimes I’ll get multiple debilitating migraines a week

I let my hr know and applied for medical help - I’m on like seven different medications just to get my days down to 12-16 a month instead of every day. When you go through hr they don’t tell partners and other attorneys what the problem is, which is what I was worried about because, like you said, even though it’s a real disability it feels kind of weird to use an excuse. I work for a firm that is notoriously a sweatshop too, so I’m sure less intense places would be even more understanding.

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Yes, I have had chronic migraines since I was 5. My neurologist basically said I’ve tried everything on the market so there is nothing more they can do for me. I have to call out sick but it was always frowned upon.

No, but my mom has. They helped her for a while. My neurologist said I wasn’t a good candidate for them because I also have a heart condition from being born prematurely.

Mine didn’t get really bad until after the pandemic, and working from home has helped me manage. I clued my partners in that they were effecting my productivity when they got really bad (stroke like symptoms, couldn’t move half my body, etc.) I think telling them how bad the symptoms were helped them realize how serious it was. I also struggled trying medications, a lot of them affected my cognitive functioning severely (like Alzheimer’s, like I forgot I was driving while I was driving, definitely avoid topomax). I wish I had communicated that more with the partners as well. Im sure they wondered why I was so out of it.

I’ve been on it since freshman or sophomore year of hs, so by the time I tried going off it I was 6-8 years in 😭

Sorry you are dealing with this! I have had chronic migraine since 2017. Under the care of a neurologist we’ve tried a lot of preventatives (rescue meds don’t work for me Bc it’s chronic). And over the years I’ve discovered things that help make them more manageable. Currently I do this: Zoloft 50 mg is the preventative, Botox for migraine every 3 months, I try to exercise most mornings, I get massages once per week (keep neck loose helps me), and I bought the book Heal Your Headache and try to follow that diet as best as possible (I haven’t given up coffee), and I try to sleep at least 9 hours per night. With all of this I’m not perfect but it’s more manageable. I hope you find a combo that works for you!

I’m fortunate enough that I only get them 2-3 times per month (typically triggered by hormone changes), and they only last for about 12 hours, then 24 hours of postdrome. So my method of “struggle through pathetically with my eyes watering if I have to, use some sick time and work a half day if I don’t” might not work if yours are very frequent… in that case, I might ask for a reduced hours schedule (if you can take the financial hit) and go through HR to make clear that it’s a medical issue. That’s what a friend of mine did until she could get hers under control (at an AmLaw 10, and she’s still there 4 years later).

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