9 to 5 migraine

Employers are learning that workers' disabling headaches can be brought on by stress, poor ergonomics, or not eating


A few months ago, Penelope Birckhead was in her office at the University of Maryland Medical Center when she felt a migraine coming on. She went to the ladies room and splashed cold water on her face. She tried to pull herself together, but the pain only got worse. "Reading intensified the pain, the phone ringing intensified the pain," recalled Birckhead, an administrative assistant in the neurology department at the medical center. "[I] just wanted to crawl in a dark corner. So I had to leave."

Her reason for heading home from work early is not uncommon. Medical experts say migraines are a major cause of workplace absenteeism. They are also a significant problem for those who stay at work during a migraine, suffering at their desks in silence.

With symptoms such as nausea and lack of energy, medical experts say, working with a migraine often can affect an employee's productivity.

Migraines are disabling headaches, but they are often accompanied by a host of other symptoms. They can affect a person's concentration, energy level and mood, and can create added sensitivity to light and noise, said Dr. Roger Cady, founder of the Headache Care Center in Springfield, Mo. They also can cause vomiting and diarrhea, experts said.

"Other than the flu, it's right up there as a cause of work absenteeism," Cady said.

Cindy Gates, a clinical consultant for Aon Consulting in Baltimore, said migraines increasingly are being recognized as an issue for employers. Dealing with migraines in the workplace is in the same category as pain management for problems like arthritis and back pain, she said. "More and more, there's a recognition that migraines fall into that area of pain for employers," she said.

Nearly 30 million Americans are estimated to suffer from migraines - the National Headache Foundation estimates nearly 10 percent of Marylanders get them. Migraines are three times more common in women than men and are most prevalent for people between the ages of 25 and 45 - important years for people's productivity at work and at home, Cady said.

People who come to work during a migraine don't perform at their peak, according to experts. Some don't work as fast and may make mistakes they wouldn't otherwise make, medical experts said.

Birckhead, the administrative assistant from the University of Maryland Medical Center, has tried to work through migraines, only to find herself snapping at co-workers and missing details on a project.

"You really can't concentrate," said Birckhead, who has been getting migraines for seven years.

Dr. Marian LaMonte, an associate professor of neurology at the University of Maryland School of Medicine, said one of the most common problems at work for people with migraines is ergonomics. The way desks and computers are typically set up produces muscle strain that can trigger migraines, she said. So LaMonte tells her patients to be sure their workplaces have ergonomically correct computers and chairs.

Certain types of lighting and loud noises at work also can prompt migraines for some, she said. A lack of food, such as working through lunch, can be a trigger for some as well, she said.

"Modifications at work, if you can do them, can be very helpful in preventing full disability from that particular job," LaMonte said.

Suzanne Simons, executive director of the National Headache Foundation, which is supported in part through a grant from drugmaker GlaxoSmithKline PLC, said she has spoken to workers who sit at their desks wearing sunglasses during a migraine because they are so sensitive to light. "You hear about people who go into the bathroom, throw up and come back and keep working because they have to," Simons said.

When Joanne Leland feels a migraine coming on, she knows she has to go home. It starts with a throbbing on the side of her head and "extreme nausea," she said, "and I know I gotta go because if I don't, I won't be able to drive. And that's the very beginning."

Leland, a dues clerk at Local 27 of the United Food and Commercial Workers union, says she's lucky because her boss is understanding about her migraines. For her, a migraine typically means a couple of missed workdays, followed by a few very busy days at the office trying to make up for lost time.

"Believe me, there are probably some people who get fired for it," she said.

Simons of the National Headache Foundation said many employees are reluctant to admit they have migraines because they fear being viewed as less reliable, missing better opportunities or being passed over for promotions.

Earlier this year, the foundation asked visitors to its Web site how headaches affected their lives. In that survey, 90 percent of the 719 respondents said they have been unable to complete a work or school day because of a headache; 41 percent said their boss and co-workers were not understanding of their headache attacks when they missed work; and 46 percent felt their headache condition affected them in missing out on career advancement opportunities.

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