Asking for Accomodation

I am on disability leave from my job right now because I have chronic daily migraines. I've been out of work for over 6 months now. I am so bored, but I can't perform my job duties as stated with my employer because of my migraines. SO...I am getting ready to ask for accommodation and/or look for a new job that will have an easier time accommodating my situation.

Through my searches online, I've found some helpful information regarding the American Disabilities Act, but the hardest part is answering the question for myself "What limitations am I experiencing and what accommodations are reasonable/available to mitigate these limitations?"

I've never defined myself as a disabled person with limitations. Even typing that statement is really hard. But I have to get busy living here and need some accommodation in order to do that. Here is my list of things that I feel I need to get back to work in a reasonable timeframe:

1) Reduced glare screen and a flat panel LED monitor.

2) Ability to have natural light and no flourescents.

3) Scent-free or ability to remove myself from a workspace with pungent or strong frangance.

4) Limited noise environment and ability to listen to soothing music (can be with earphones).

5) Ability to leave work or miss work (either using benefit time or unpaid time as needed) when migraine is too severe to function. This will sometimes be for an entire day or possibly more depending on the migraine severity.

6) Ability to telecommute when possible if staying home with migraine.

7) Ergonomic friendly workstation to reduce stress on neck and back including supportive chair, headset, feet support and keyboard/monitor at proper heights for my build.

In return I will provide:

1) Committment to be the most dedicated and loyal employee I can be.

2) Pledge to not abuse my migraine condition for personal gain.

3) Documentation from my health care providers and specialists as needed to support and further define my accomodation requests.

I have an interview with a new company today and look at it as "practice" talking about these things with employers. Talking with my current employer is too intimidating as I fear discrimination coming back from my leave of absence. If this new job works out - great. If not, I will be better prepared the next time and might be ready to broach the subject with my current employer...

Types of Migraines

Personally I get several types of migraines (as well as other types of headaches). I am on a waiting list for a headache specialist here in Seattle and keep track of the types of migraines I get in my daily headache journal. Hopefully this will help identify if there are other primary causes for some of my pain.

TYPES OF MIGRAINES

Complicated Migraine. The aura of migraine typically lasts from 20 minutes to an hour. Some patients have prolonged aura symptoms that can last hours to days. The aura also typically ends before the headache itself begins. When migraine aura symptoms are prolonged or last into or through the headache phase these types of migraine are commonly referred to as complicated migraines. There are several forms of these complicated migraine attacks. There is ophthalmoplegic migraine where patients develop a partial or complete paralysis of the nerves that are needed for eye movement. There is retinal migraine where the patient's visual symptoms occur from the retina itself versus the portion of the brain involved in vision, as is the case for the typical migraine aura. There is hemiplegic migraine, which can be inherited and has been linked to one of several chromosomes. Patients develop stroke-like symptoms with sensory and/or loss of strength of muscles. There is basilar migraine, which used to be called Bickerstaff's syndrome. Here patients start with a typical migraine aura then progress to developing neurological symptoms related to the bases of the brain called the brainstem. Unlike typical migraine attacks where numbness can occur on one side of the body in this form both sides are affected. The headaches in basilar migraine are often at the back of the head and may result in very severe vomiting.

Hemiplegic migraine. Temporary paralysis (hemiplegia) or nerve or sensory changes on one side of the body (such as muscle weakness). The onset of the headache may be associated with temporary numbness, dizziness, or vision changes. These need to be differentiated from a stroke.

Ocular Migraine. Ocular migraine is a term which may have different meanings to different physicians. Many times, migraineurs will have just the visual warning signs or aura of their migraine attack without the headache. This occurs more frequently as one gets older and can be a frightening phenomenon. This is also referred to as acephalgic migraine, or migraine aura without headache. Some physicians refer to ocular migraine as retinal migraine, where there are repeated attacks of one-sided blind spots or blindness lasting less than an hour and associated with a headache. It is important to rule out eye disease or a disorder of the blood vessels leading to the eye as possible causes.

Exertion Migraine. This is normally a short lived migraine brought on by physical exercise (combined with dehydration), exertion through lifting or sometimes it can even be caused by a fit of sneezing or bending over.

Retinal migraine. Temporary, partial or complete loss of vision in one eye, along with a dull ache behind the eye that may spread to the rest of the head.

Basilar artery migraine. Dizziness, confusion or loss of balance can precede the headache. The headache pain may affect the back of the head. These symptoms usually occur suddenly and can be associated with the inability to speak properly, ringing in the ears, and vomiting. This type of migraine is strongly related to hormonal changes and primarily affects young adult women.

Status migrainosus. A rare and severe type of migraine that can last 72-hours or longer. The pain and nausea are so intense that people who have this type of headache often need to be hospitalized. Certain medications, or medication withdrawal, can cause this type migraine syndrome.

Ophthalmoplegic migraine. Pain around the eye, including paralysis in the muscles surrounding the eye. This is an emergency medical condition, as the symptoms can also be caused by pressure on the nerves behind the eye or an aneurysm. Other symptoms of ophthalmoplegic migraines include droopy eyelid, double vision, or other vision changes. Fortunately, this is a rare form of migraine.

Nocturnal Migraine. Many patients who have migraine will experience their attacks during the early morning hours, most commonly around 4:00 A.M. This headache often awakens the patient. Recent evidence suggests that these attacks are related to changes in adrenalin and related substances that occur on a cyclical basis, and which reach their peak release during these hours. Alteration in sleep cycles may also provoke migraine attacks. When sleeping beyond the normal wakeup time, a patient may be awakened by a migraine attack.

Cyclic Migraine Syndrome. Patients with cyclic migraine usually experience ten or more attacks per month. These headaches differ from cluster in that they are long-lasting and do not have associated typical cluster symptoms. Patients do have typical migraine symptoms during these headaches. It has been shown that lithium carbonate is of some help in these cases. Careful monitoring of the level of the medication in the blood and of thyroid functioning is needed with this medication.

Abdominal Migraine. Abdominal migraine is one of the variants of migraine headache. It is also known by other terms including "periodic syndrome". This variant most typically occurs in children. They usually have a family history of migraine and go on to develop typical migraine later in their life. The attacks are characterized by periodic bouts of abdominal pain lasting for about two hours. Along with the abdominal pain they may have other symptoms such as nausea and vomiting, flushing or pallor. Tests fail to reveal a cause for the pain. Occasionally there may be EEG findings suggestive of epilepsy but this is rarely related to seizures. Medications that are useful for treating migraine work to control these attacks in most children.

I also find this website really helpful - talks about the anatomy of migraines. I am stuck in the cycle and use it as a great starting point for recognizing where I am in my migraine cycle.

7/20/08: Found this great site that gives a wonderful breakdown of the different types of migraines : http://www.healthcentral.com/migraine/types-of-headaches.html

Migraine Shame

I think that most people who suffer from chronic migraines have some form of migraine shame. It sneaks up when you tell someone you can't function the way you would like because you have a migraine. It washes over you when you get the skeptical look and half hearted "Okay..." from someone who hasn't ever had a migraine in their life.

Sometimes when my migraine is bad in the morning and I try to suffer through and go one with life, I get asked if I had a wild time the night before. When explaining that I have a headache - I get the blanket advice to not drink so much next time and then my head won't hurt. Even worse - I've been asked if I had a substance problem because of seemingly erratic behavior during my more debilitating migraine pain. Shame.

Back when I was working, there was a day when all the telltale signs that I was about to launch into a doosey of a headache hit and I knew that I had two options - drop everything and get home before I couldn't drive myself anymore or lock myself in a conference room until it was over - who knows how long. I choose to go home, but received feedback a few days later after recovering from a good friend that one of my co-workers made some derogatory comments about me leaving work because of a headache. This person said that must be a woman thing and that is why they didn't like to work with women. Wow. Shame.

Migraine Shame. Hits me sometimes when I least expect it and reminds me how much opportunity there is to educate people about the disabiling effects of migraines on peoples lives.

Sunshine

I used to revel in a nice sunny, warm day - and parts of my soul still do - but bright, piercing light is one thing that frequently makes me want to crawl into a dark closet to combat migraine symptoms.

Light - specifically bright summer sunshine - is a constant trigger for me. I can wake up feeling fairly stable and all it takes is the contrast between my dark bedroom and my bright kitchen to start my auras spinning.

My husband doesn't experience migraines (fortunately) and I've tried to help him understand what I see when I have an aura. Here are two images that I found online that help illustrate what the world looks like when my head starts to plays tricks on me.

These images are from WiseDoctors.com.

Because I am living DESPITE my migraine and not in fear or because of my migraine - I am going to revel and enjoy this fabulous Seattle sunny day in my garden for the part of my soul that needs nourishing.

Welcome to the Blogging World Self

Why am I doing this?

Because I need a vehicle to express my migraine experiences. I know I can't be the only person out there who is suffering from constant migraines.

Why am I seeking an outlet on the Internet to journal and write about my migraine experiences?

Because I figure it's "greener" than writing on paper and easier than going to my local hospital support group for headache sufferers.

What is it that I hope to gain from this?

I hope to find other people who live happy, successful, productive lives to help encourage me to keep hoping and striving.

My Story...

I've had migraines for most of my life that I can recall. I remember as a child having these debilitating headaches on one side of my head and not being able to see "normally." When I hit puberty, a doctor suggested that I probably have what are called "migraine" headaches. Until I was about 19, I didn't seek treatment for my headaches; I just called in sick to work, missed school or tried to just tough it out.

From about the age of 20 until last December, (with the exception of some bad months and recovering from a closed head injury) I had about a migraine a month or so - maybe less sometimes. But starting December 18, 2007, I've had a constant daily migraine of varying intensity. It hasn't stopped. I am stuck in a migraine loop. I can't work the job that I had, I can't live the life that I know. I am disabled at 28, but I am exhausted living this painful existance and am going to do all that I can to get on with my life.

Eventually - I would like to look back on this time in my life and think about what a learning opportunity this all was. I also hope that maybe I can help someone else who is suffering from migraines to know that they aren't alone.

So that is my story.