When Migraine Leads You to Rethink Your Career Path

Episode 234: When Migraine Leads You to Rethink Your Career Path

Lindsay Weitzel, PhD:

Hello everyone, and welcome to HeadWise, the videocast and podcast of the National Headache Foundation. I'm Dr. Lindsay Weitzel. I'm the founder of MigraineNation, and I have a history of chronic and daily migraine that began at the age of four. Today, I have brought on Paula Dumas to talk to us. Hello, Paula. How are you today?

Paula Dumas:

I'm great Lindsay. How about you?

Lindsay Weitzel, PhD:

I'm doing great. I'm excited to talk to Paula today. Paula is the founder of MigraineAgain.com and a producer and co-host of the Migraine World Summit. She also happens to be a lifelong migraine warrior who shifted from a corporate career at CNN, Apple and Disney to migraine advocacy. I wanted to talk to her today because I planned an episode on career and job change, and what to do when you feel you need to make a change due to your migraine disease. And I think a lot of us stay in that place for a long time. Do we need to make a change? Can we make a change? So, I'm hoping that everyone gets something out of this episode. And I know Paula has a lot to contribute. So, Paula, why don't you just begin by telling us your own story of career change due to migraine?

Paula Dumas:

I would be happy to. And thank you so much for having me and for continuing to speak to this community with your podcast.

Lindsay Weitzel, PhD:

Thank you for being here.

Paula Dumas:

Yeah. Of course. So, I think like many people with migraine, we continue to struggle and reinvent ourselves over and over again as this disease continues to change the way it manifests in our lives. And I was kind of in denial until about age 23 that I had migraine. I didn't know it because my symptoms were abdominal for the most part.  And so, at 23 I had a nasty bike accident. And I was also working in my first big corporate job. And I didn't know what to do. I did get diagnosed pretty quickly at that point, and I did go chronic very quickly at that point. And so, I really had to wrestle with it.

And at the beginning I was I suppose naive. Aren't we all? I was naive, and I told people what I was dealing with, how I got diagnosed with migraine and it's chronic and almost every day I'm having an attack. And so, I was doing lots of exercise and things that I knew how to do. I was following the doctor's orders, but I was working in a pretty intense job. It was literally featured, it was a corporate marketing job. And it was up or out kind of thing. You had to get promoted every year or you'd be gone. So, I realized that maybe it wasn't the best thing to advertise the fact that I was dealing with something that others weren't dealing with. Everybody was trying to put their best face forward, so I was kind of quiet about it at some point. But that company was extremely supportive of me. Literally had somebody in their fitness team that would help me and do massages and things like that and would kind of help me abort attacks.

So, then I transitioned and I went through a few different jobs. And as I kind of climbed the corporate ladder, I realized what a disadvantage this was. Because not only did it interfere with my ability to keep my commitments, which is really, really important, but as word got out and you dealt with different bosses, not all of them were very supportive. Not all the companies had policies that were supportive, and not all the bosses were supportive. Some were amazing and some were difficult. And people, if you're in a very competitive industry, will kind of use anything to say well, she can't handle stress. She has stress, she gets migraine, and then she might not show up for the meeting.

And those kinds of things would happen. So, I accepted it for what it was and continued to try to grow and find ways around it. We are all problem solvers and migraine really teaches us that we have to plan ahead. We have to have contingency plans, plan Bs. We have to be team players. We have to take a couple people into our confidence who can help us if an attack comes. And we need to overdeliver because we're already in a circumstance where we're starting with one leg back.

But the good news is we're not the only ones dealing with this. And people have all kinds of issues in the workplace. Some of them might be going through a very painful relationship thing like a divorce. Some of them might have a sick child at home. One of my work friends revealed that she had diabetes. And she showed me her port one day, and I thought, okay, so I'm not the only one carrying something like this.

But it can be very difficult to continue to show up, particularly in a job where you punch a clock or where you have long hours or where you travel. And in my case across time zones and around the world, all of these things were very difficult. After 22 years, I hit a wall. I had tried everything I knew how to try to be able to stay in that role, but it was simply not possible. I was dealing with attacks 25 out of 30 days a month and had a roundtrip ticket to the emergency department.

I was fortunate enough to have some career success. And I was fortunate enough to have some bosses who were supportive, and at the very end, the last three years, I got some flexibility that I didn't even know I could ask for, which we can come back to in a second. But at some point, you just realize this isn't working anymore. And for me that was in my early 40s.

Lindsay Weitzel, PhD:

It occurred to me, as you were talking, that we have some opposites in our story. We could speak to some of the different people who might be listening because my chronic migraine disease and chronic pain began in my first memory, and I always felt like I was taught to hide it so much of my career. Most of my career I didn't speak about it, but I made sure through grad school, I worked through grad school, and I made sure that I had careers and jobs where there was no clock to punch. It was kind of like, where's Lindsay? Oh, she's at the other office. Oh, here she is. And it was flexible because I had to.

And for years no one knew what was wrong. And there's also cons, great cons to that, because if you're having really bad brain fog, everyone just thinks you're really done that day, and they don't know why, stuff like that. There's so many cons to both ways, and it can be very difficult. We're going to get to the stigma and things like that, in a minute.

You have done so much work with this background of yours in the migraine space and with Migraine at Work. But honestly, it was an article that you wrote about people who shifted to more migraine friendly jobs that caught my attention when I was planning this particular episode. I thought it was such a helpful article. I really loved it. These people you were writing about and these ideas in this article, was finding ways to take better care of yourself physically and still maintain your income. And I just want to inspire our audience with some of this information today. And I'm wondering if you could just maybe start by telling us what you feel are some of the least migraine friendly aspects of certain work environments.

Paula Dumas:

One of the wonderful aspects to my advocacy career that's been going on for over a decade now is the opportunity to meet so many brave, courageous people who work in a spectrum of different kinds of jobs from healthcare to construction to education to business and government, and to understand how they are managing in the workplace. How are they doing it.

And so, I've learned so much from them, and I love to repeat their stories because it begins to give people hope about what you can do. Like if you're in a job and your boss thinks that her husband or his wife, who just has a little headache is the same thing as a migraine, why don't you just take an aspirin and get over it and get back in the game, you're at a big disadvantage. It's very difficult to educate, educate up and be heard. It can be difficult to engage HR. Sometimes what you need is accommodations in the workplace.

So going back to your question, the accommodations in the workplace that are the most helpful or the most difficult aspects of being in the workplace, oftentimes are things that you can't control, like fragrance and light. And one of the beautiful things of the pandemic that has happened is that we've all gotten much more flexibility in our jobs where you can if you have a job that doesn't require being on site, like if you're not a teacher or a doctor or a construction worker, you might have the opportunity to work from home.

But there's a little bit more flexibility in our jobs. I mean, it used to be 9 to 5, 8 to 5, 7 to 6 in my case. It used to be like that. And it's not as much like that anymore. And people are much more attuned to the results that their employees generate and taking care of their employees because they realize that we can be make or break assets in an organization.

So, I think the things that can make it most difficult are like bright fluorescent lights or uncontrollable smells from the workplace, people wearing too much cologne and not really caring how it affects others, can be a big one. And then not having any flexibility, you must show up like people in retail jobs, you must show up at this time, and you cannot leave until this time. These are really hard.

Lindsay Weitzel, PhD:

I think a couple of the most difficult ones that I think of is, having come from a clinical research and hospital background like nursing when you have to be there and then you're on your feet and long hours. Those are rough. And you mentioned construction, and I hadn't even thought of that. I cannot imagine the elements being out in the elements or something like that and the noise. Some of that stuff would be so hard to get used to. So, some of these jobs would be really difficult. So how about let's throw in what are some of the most migraine friendly environments that you've run across or thought about?

Paula Dumas:

I think any of those that provide flexibility. So, where the organization that you're working for is measuring you based upon your results rather than the time that you show up. So, let's say you were in retail, if you were measured on how much you sold or what your customer satisfaction levels were, as opposed to how many hours you worked, that would be a better environment.

And anything that's attached to sales is of course easier. But whatever the metric is, if you're delivering education or you're delivering health and you're a frontline worker, how well you do with those things is what matters. So, somebody that looks at the results that you generate, number one, that's a very good workplace. It gives you schedule flexibility, is good.

Some organizations understand that migraine, mental health, any other chronic disease oftentimes requires a quiet dark space, a quiet room. And those that have been wise enough to put those in are able to retain workers like us and like many others who are dealing with these other issues.

I interviewed a woman one time, and she worked at a big home improvement warehouse with fluorescent lighting. And you can imagine the beep, beep, beep and the forklift and all the sounds and these bright fluorescent lights that are coming down. And she had incredible support from her manager, and they put in a quiet room for her. And then all these other people started using it.

Lindsay Weitzel, PhD:

That's nice.

Paula Dumas:

I know right.

Lindsay Weitzel, PhD:

That's a good story. My next question is, honestly it could be a whole episode in itself but I think it's important that we touch on it, how big a role do you think stigma plays in the need for people with migraines to make changes in their job or career?

Paula Dumas:

I think stigma is an insidious little characteristic that happens. And because we are human, we naturally have bias. All the decisions we make, all the judgments that we make in the blink of an eye, are informed by our experience, which is inherently biased. And so, you go back to the boss who had a relative who had a headache which was not migraine, for example. Or maybe they themselves had migraine, but they had a much more mild episodic form. Oh, I had a migraine once. These things form stigma. And there's spectrum stigma. So, people who have much less severe form versus those who have a very severe form. And it's happening in the workplace.

And the way you know it's happening is if your performance is really good and you can be honest about that, you can say, yeah, I did do a good job on that, but it's not being rewarded in some way. And you see other people do something similar and it is being rewarded, and it keeps happening over and over again. Maybe you miss a promotion or get passed over, or you don't get a particular opportunity that you really want, but it could just be personalities in the workplace, but it could be stigma.

I had I had a boss who I worked with at two different companies, and we were colleagues at Apple and then we worked together at Kodak. And he was amazing. He was really supportive. He understood me for my strengths, and he also understood my limitations. But he said to me, and he literally put in a performance review, is I'm looking for something negative to put down here for you. He was a fan, which was so kind. And he says, I don't think you respond to stress. Well. And I was like, what? What are you talking about?

And he was not wrong. He was sorry, but he was not wrong that he did not respond to stress. Well, what he could see that I couldn't see at the time and was trying to tell me very kindly was that my shoulders would hunch up. I would get kind of like fired up. I would respond to the stressful situations, and that was not helping my body or my brain. And so, I needed to really recalibrate my response to stress because stress was going to happen. It was inherent in the job. And I needed to be more humble about accepting that criticism at the time, understanding it and digging into it.

Lindsay Weitzel, PhD:

Interesting. That's very interesting.

Paula Dumas:

But it sounded offensive at the time.

Lindsay Weitzel, PhD:

I was going to say, too, on the concept of stigma, I think a lot of people think that if you work in the medical field, there's less stigma and people will understand your migraine disease. And it really can be the opposite, whether it's because people are tired of dealing with people who are in pain and they don't want to deal with employees that are in pain, whether it's digging into that, but I don't feel that it's necessarily better in the healthcare field, maybe unless you work for a headache specialist.

Paula Dumas:

Well, one of the things that we do with Migraine at Work, is we go and look at all the different industries and how many people with migraine are represented in those. And health and education are number one and number two, not surprisingly, because it skews female. We have a disproportionate number of women working in those fields. But I also think in terms of health, shift work is really brutal on migraine because if you disrupt people's sleep, you want to go back to triggers, you disrupt people's sleep, or you require them to travel across time zones, which naturally disrupts the consistency that migraine brains like. These are things that can be really, really difficult. So, people say, oh, I'm going to go into health because then I won't face the stigma anymore. That can be true, but it isn't always true.

Lindsay Weitzel, PhD:

It can be difficult in a forum like this to speak in general to a large and diverse audience about career change, because we don't know what you know, there's probably a mix of everything out there. But when someone is at that tipping point where they need to make a career shift and they're ready to think about it, talk about it, read about it, what advice do you think they need to hear?

Paula Dumas:

Well, first, are you at the tipping point? Or are you in denial about the tipping point? So, I think understanding if work isn't working anymore, maybe if you're missing out on opportunities and you can see it.

Lindsay Weitzel, PhD:

Do you mean, career opportunities or…

Paula Dumas:

We'll say career opportunities. But in my case, I also had a couple of small children, and I was giving my best at work and coming home and not being the mom that I wanted and needed to be because I would just crash and suffer and my husband would have to step in and take care of the kids, or a friend would have to pick them up or… it wasn't working. It wasn't working. It was definitely broken. And I was kind of in denial about that because of the whole conundrum of I needed the job for the insurance and the healthcare coverage and that whole thing that so many people are stuck in.

So, I think the scary thing is changing. Change is scary for all of us. But one of the things I know about people with migraine is they're very, very courageous, very brave, get up every day and face the day knowing that that whole day could be derailed by a surprise attack. And you're going to have to change everything to pivot to manage that attack. And everyone around you, you're going to have to help them understand and pick up the slack or support you in some way.

It requires agility, resilience, courage. Migraine, the more chronic it is, the more it just breeds this into you. So, for people who are scared about this change, I will say maybe don't be as scared because you're braver than you know. We exhibit that every day.

Lindsay Weitzel, PhD:

I love that message.

Paula Dumas:

Yeah. And it could be better on the other side. Better doesn't always mean you're going to make the same salary or have the same benefits. Better can be you have a better quality of life. You have more peace every day. You're not acting in the workplace. You can be your authentic self. Better means maybe you get to test things about yourself that you didn't know. Like actually lean into the talent you've been given as opposed to the job that you're sitting in.

Lindsay Weitzel, PhD:

That is very well said. That's very true. I would like to hear one or two of your favorite success stories or perhaps most migraine friendly jobs that you heard from people who have made successful career change due to migraine disease.

Paula Dumas:

Yeah, that's a great question. And we could go on. That article that you mentioned if you have the ability to link to it, will give people even more ideas than I can get into here. But I would say, let's just take some of the top careers. So, let's say you're an educator. Frankly, I've visited my kids’ classrooms, especially in elementary school, I cannot imagine doing that job every day with excellence because kids are kids. They're just wild and crazy and unpredictable and wonderful. And you've got the lights and you’ve got the school bell and you've got all these things that are your potential triggers that you're dealing with in the workplace. And you can't just step out. You got to have somebody there for you.

So, somebody who's an educator, for example, could potentially shift to tutoring. Or being a sales rep for educational products that they're passionate about, right? Or being a floating teacher who is able to go in as opposed to a teacher with a classroom full of kids. Those are all more flexible things than facing that classroom.

Somebody who, let's just say, I had a doctor who I knew. She was a surgeon, and she would get migraine with aura. And she could get an aura in the middle of a surgery. Now just imagine that, right. The liability, the guilt, you got six people around you not to mention the patient. I said I hate to tell you this, but I think you're going to have to consider for safety and liability reasons and your own health, a shift. I know you love this. You trained for it for half your life it seems. But you might need to take a shift to something else.

And so, we talked about the things that she could potentially do, and we talked about doing devices like some of the robotics. She was working with robotics that she could rep those or she could go on a speaking tour and speak about those to other physicians. She could do continuing medical education for others. She could go the academic route and teach medicine to up and coming doctors and physicians. There's a litany of things that you could potentially do in the healthcare ecosphere, aside from being in surgery.

A police officer, oh, my gosh, a police officer who's carrying a gun and on patrol. That was a crazy story. And she knew herself that she could not continue doing that because she felt guilt about putting her partner at risk when she would have attacks and she could not see clearly or hold her gun steadily. So, these are sort of very critical decisions. Another person who I advised he was in the construction field, and he was working on big corporate kinds of projects, big commercial builds. And he moved into home construction.

So, he understood, and he went into partnership with another contractor. And together they managed it so that if, Chris was his name, if Chris went down, the partner could at least show up on the job site and keep things moving. But he was the one who made me aware of all the smells and the sounds and the challenges in construction that are difficult. It requires creativity, but it's absolutely possible. And the quality of life on the other side and your health can be much better.

Lindsay Weitzel, PhD:

Those are amazing stories. Thank you so much, I love them. I keep flinching every time you mentioned construction because we just added on to and renovated our home, and I could hardly come visit it. The smells, the sounds, it's just too much for someone with migraine I feel like. So, I'm really impressed that people who can work in that field and have migraine. So it's very interesting. I love hearing these diverse stories, so thank you for bringing us those stories. Those are awesome. So, let's name some things that we know that people can do. What do you think are some of the best resources for people considering changing to a more migraine-friendly career?

Paula Dumas:

Well, I have to recommend MigraineAtWork.org. It's a nonprofit that is a coalition between the World Health Education Foundation, National Headache Foundation, Headache and Migraine Policy Forum was very involved in the early days, some other leading experts are engaged with it. And there's so much content there that's absolutely free and available for everybody to find resources to make things work. So that's that's number one.

Through the Migraine World Summit, I've had the opportunity to interview some really amazing attorneys and workplace experts and people whose stories have helped to inform some of the work we do. Those might be linked on MigraineAtWork.org, but one that I like in particular is the Job Accommodation Network, JAN.[1]  It’s a nonprofit. But it will give people some great ideas.

And then I think LinkedIn. LinkedIn can can be a really interesting resource. If you go on it and you begin to look at what somebody who does what you did, what career paths they took. So, let's just say you were a nurse at a hospital system, and they wanted you to work night shifts, and there was no negotiating it. And those night shifts were triggering attacks after every time, and you just couldn't get out of this endless cycle, and you thought, why don't these people understand? I have a health problem the way these people we serve have a health problem. But for whatever reason, you've got a boss that you cannot outlast, right?

If you go on LinkedIn and you look up people who are nurses and have worked overnight shifts or something like that, whatever the keywords are, and you look those up. You can begin to look at their career paths, and you can bet that if you look at ten of them, one of them has migraine, two of them could have migraine, and they might have had to make a change because of their job and they might not talk about it. But it could be very useful. So those would be some good resources to go through.

And then an odd one, but I'm just going to throw it out there. It's called StrengthsFinder. It's a book that was written, maybe a decade or more ago. And I think there's a 2.0 version of it and has an assessment in it.[2]

Understand your strengths, because one of the best ways to keep a job you love, or that you need, is to know what you are uniquely qualified to do and what you are exceptionally good at. And if you can navigate your way into that role in an organization where it's leveraging your strengths and you do it better than anyone else, because we all have those sort of secret skills, it will help you dramatically to keep that job. Every industry has its sort of front line where those are the most valuable people in the organization. Make yourself indispensable. And part of making yourself indispensable is understanding your strengths.

Lindsay Weitzel, PhD:

Oh, that's great advice. I love that, I really do. As you were talking, I felt like there was one other thing that I felt like we should mention to people that might be at this tipping point. It doesn't always feel like a tipping point. There were a number of these changes, I made change after change after change before I finally got to where I was like, oh, we're totally changing this. Because I had always been in pain and I was used to it, and I was keeping it so secret for so long. It often just felt like failure to me when I was really just making a change that was more accommodating to a secret physical illness that I had. But it felt like failure because I had this secret that I wasn't telling anyone.

And then in the end, all of a sudden, when I was finally admitting, okay, Lindsay, this is what's wrong, and you've been diagnosed with this forever, and you just don't tell people. And this is going to be a better move for you. And I made a huge move out of clinical science, clinical research, etc., and did something totally different. That's when I that's when it felt like it. So if it feels like a failure, it's not. Change is not failure.

Paula Dumas:

Change is not failure. And hiding is not healthy.

Lindsay Weitzel, PhD:

Exactly.

Paula Dumas:

Secrets can make you sick. It can literally make you sick. You feel like you're performing at work and hiding what's actually going on. I mean, I actually I understand the reasons for it. This is a personal choice about whether to come out or not. But if you are hiding at work, which many people do with migraine, it could be making your migraine attacks worse because elevates your anxiety every time you cannot be your authentic self.

Lindsay Weitzel, PhD:

Yeah. So, I just felt like maybe it was a good idea to say that for the people out there who, for whatever reason, are hiding it. It might feel different right now, but if you make a change, it could change your whole world and make you a lot better.

Paula Dumas:

And if you hadn't made that change, Lindsay, we would have the blessing of listening to you in this podcast. So I'm glad you did. I'm glad you were courageous enough to make that big leap.

Lindsay Weitzel, PhD:

Very sweet of you to say so. Is there anything else Paula? This has just been so awesome. I love this conversation. It's been so educational. I think it's probably helped so many people. Is there anything else you'd like to add related to this topic before we go today? Is there anything we missed?

Paula Dumas:

I think you don't have to do this alone is probably the thing I would echo more than anything. There are so many people in this situation, and there are resources available to help. There are people available to help. I don't have the capacity to help everyone. But if there's somebody listening to this and they are in a desperate state, I would love to encourage them. I think I think we need to encourage each other in this community because it is really, really challenging and we need to support each other.

When we started Migraine Again in 2014, we were committed to only hiring people with migraine or another related headache disorder. And the same is true for Migraine World Summit. And do you know that both of those organizations function very well with an amazing team of people.

Lindsay Weitzel, PhD:

That's great.

Paula Dumas:

Because they're all so committed to it, and they can be transparent, and they can leverage their strengths. And people with migraine make incredible employees. Agile, team players, resilient, courageous.

Lindsay Weitzel, PhD:

Used to working hard

Paula Dumas:

Yeah, absolutely. And those are some strengths. If you do StrengthsFinder, you'll discover these are things you can use anywhere. And so, understand that about yourself and lean into your strengths and stop apologizing for your weaknesses. It's just the biological lot you've been dealt. And sometimes we have to pivot.

Lindsay Weitzel, PhD:

Well, thank you so much for all this amazing information. This has just been an awesome episode. Thank you everyone for tuning in and tune in again to our next episode of HeadWise. Bye bye.

Paula Dumas:

Thank you, Lindsay.

[1]  https://askjan.org

[2] Rath, Tom. StrengthsFinder 2.0. New York, NY: Gallup Press, 2007.