Erika Penzer Kerekes has had migraines for more than 30 years. When she has one, the throbbing pain in her head can make it impossible to do her job. She's a communications manager for a nonprofit in Los Angeles. "I'm usually able to abort the headache soon after I feel it coming on by taking medication and having a cup of coffee. But there have been times when I've had to shut the door to my office, turn off the lights, wrap ice packs around my head, and stretch out on the floor with my feet up the wall until it passes," she says.
Migraines can be made worse by stress, exhaustion, bright lights, and noise. That can make the job a tough place to be. More than 90% of people with migraines are unable to work while they're having one. According to the Migraine Research Foundation, Americans lose 13 million workdays each year because of migraines.
Kerekes says her boss knows her situation and is accommodating. Plus she says her company has a generous sick-leave policy. But not everyone feels so free to talk about having migraines.
Can you be honest about your migraines? Is it really OK to miss work for a headache?
To Tell or Not to Tell
The decision to share the information with your supervisor depends on your situation. Many people prefer not to discuss it. Instead, they just try to power through the day. But if your migraines are severe and happen often enough that you need accommodations, it's best to be upfront, says Merle Diamond, MD, president of a headache clinic in Chicago. "Tell your boss you have a medical condition and are working with a health-care provider to manage them as best you can," she says. In many cases, it may be better for your boss to know the truth than to draw her own conclusions about why you're wearing sunglasses in the office or coming in late.
"There is a lot more info out there about migraines today. And people are getting better care at work," Diamond says. But it wasn't always like that. "Migraine used to have a real stigma. People would say, 'Oh, you just can't cope, you can't handle the stress of the job,'" says Diamond. She points out that migraines are a condition that deserve the same support and empathy as other debilitating conditions.
Your Disability Rights
If your migraines are so bad they cause you to miss work, you may qualify for disability or the Family Medical Leave Act (depending on the size of your company). Talk to your doctor and your human resources department to see what accommodations can be made for you at work and what type of leave you're entitled to.
If You Have a Migraine While You Are Working
If you feel the telltale signs of a migraine coming on, take action as quickly as you can.
Always have your meds on hand: Whether you take over-the-counter medications like ibuprofen or acetaminophen (with or without caffeine) or prescription triptans, make sure you have your supply with you at all times. Take them at the first sign of a migraine.
Drink caffeine: "When I get a migraine at work, I often take a break to walk to the coffee shop and get an espresso," says Leorah Haberfield, who works in a theatrical management office in New York and has suffered from migraines for the last 10 years. "The exercise and the shot of caffeine really help." Caffeine has been shown to reduce the pain of migraine. Many migraine medications include it as an ingredient. And many people with the condition drink coffee, tea, or cola as part of their treatment plan.
Have ice available: Kerekes finds that keeping an ice pack on her forehead and the nape of her neck can help ease migraine pain. Not only does she keep ice packs in the office kitchen, she also keeps a scarf in her desk so she can wrap the packs around her head.
Find a peaceful haven: It can take up to an hour for your migraine to go away after taking your medication, says Diamond. While you're waiting, find a dark, quiet place to rest and wait it out.
Stretch and relax before work: If you can start the day with a yoga class, it may help with migraines by easing stress and reducing muscle tension.
Avoid Your Triggers
Migraines happen when your body reacts to internal and external triggers by releasing chemicals that irritate and inflame blood vessels in the brain. This causes moderate to severe pain, Diamond explains. It may be impossible to keep away from all your triggers. But there are many modifications you can make to your lifestyle and office to help stop a migraine before it starts.
Eat regular, healthy meals: Working straight through lunch can bring on a migraine. "Make sure you take regular breaks to eat and to drink water," says Diamond. Dehydration is a trigger, so it's important to keep a bottle of water at your desk. Starting the day right is a good idea, too. Haberfield says she makes it a point to have a protein-filled breakfast like eggs or yogurt before work.
Make sure your desk, chair, and phone are comfortable: "I've had migraines since I was a teenager. But they got really bad about 12 years ago when we switched to electronic medical records at my practice, and I was on the computer all day long," says Cori Levinson, a physician in Chicago. An ergonomics consultant pointed out that all the doctors in Levinson's office were typing at their computers while holding their phones scrunched between neck and shoulder. Switching to headsets and ergonomic desks and chairs helped ease her symptoms, Levinson says.
Dim the lights: This can be a tough one. It's not always possible to change your overhead lights, especially if you work in a cubicle, store, or factory. But try to control what you can. If you work at a desk, you can dim your computer monitor or use an antiglare screen. And make sure you're not getting a glare from windows or overhead lights. Using curtains or indirect lighting can help. Diamond also recommends taking regular breaks if you sit in front of a computer screen all day.
Avoid strong odors: If the person sitting next to you is a fan of perfume, cologne, or scented soaps, the smell may trigger your migraine. You may want to explain your condition to your coworker or your supervisor. One solution is to ask the person to avoid using strong scents at work. Another option is to ask to have your workspace moved to the perimeter of the office so you're not surrounded by as many people, suggests Diamond.
Make sleep a priority: Since irregular sleep or exhaustion (or both) can trigger migraines, it's important to get a good night's rest. Don't let stress at work keep you from getting your rest. "I take a dose of melatonin every night to get a solid night's sleep. And that really helps," says Haberfield.