Been out of work for three weeks due to vestibular migraines....

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Hey everyone! (I apologize for the long post).

Overall, I’m a healthy 31 year old female. I was diagnosed what was thought to be Menieres Disease about 2 1/2 years ago. When the symptoms first started, I was working as a nurse in a hospital on a busy med-surg floor. I initially presented with constant vertigo, tinnitus and pressure to the left year. The symptoms were almost constant for months. I tried a multitude of medications, all of which were unsuccessful. Eventually my specialist moved on to Dexamethasone injections into my ear. I received three rounds with no relief. My doctor was about to send me for another opinion, however, gradually my symptoms began to improve to where I was symptom free for about a year.

I was cleared to start working again. I unfortunately had lost my previous job at the hospital because I was unable to work for months (I left in good standing with them though.) Eventually I started working again as a nurse but this time doing telephone triage all day for a different company. I basically look at a computer screen for 10 hour shifts talking to patients all day. A few months into the new job, my symptoms returned. They weren’t bad a first but have gotten progressively worse over the past 8-9 months. I’m currently in the worse flare I've been to date. The symptoms consist of horrible vertigo, tinnitus, pressure and intense pain to my left ear but now with boughts of intense migraine pains. The symptoms have been on going for three weeks straight with no relief at all. I have been out of work the entire time (three weeks) and have no sick time left. I’m not eligible for FMLA yet. Unfortunately, there is just no way I can try and work and focus on a computer the way I feel with the intense vertigo.

I saw a specialist today who actually does not believe I have Ménière’s disease as my hearing and balance tests were all normal. He believes I have vestibular migraines. He referred me to a neurologist (which looks like may take months to get into to see). I’m unaware when I’ll be able to return to work as the symptoms have not let up. I did start on Nortriptyline to see if it will help. My concern is (thinking back now) the migraines may be further exacerbated from the continual computer use from my job. The symptoms did start up again soon after I started there. I have adjusted the brightness on the computer screen with no improvement, try to take multiple breaks looking away from the computer. I find I get dizzy (even before this latest flare) if staring at a computer screen for too long. I wonder if I’d be better at a job with less continual computer time. Maybe something with more direct patient care? I’ve been at my current job for 11 months, and since I don’t qualify for FMLA, i technically don’t have job security. I’m in the process of getting approved for a continuous leave under the ADA, but of course work wants to know how long I’m anticipating being out (and rightfully so). I unfortunately tell them I’m seeking treatment now and can’t give them a good answer. I feel terrible the position it puts my coworkers in being short staffed and part of me questions if I should just take a few months off from work entirely while I try and find a successful treatment for me then once better, start looking for a new job. I’m unsure if I do resign now, if I’d be still eligible to apply to this company again when well enough in the future (as they are a large company that I’d still like to work for in the future, just a different position because of my situation) or would that completely hinder my chances. I also wonder if it would create a problem applying for another position even for a different company as I’m sure they’ll question why I left etc.

Sorry for rambling, just looking for advice and suggestions as I’ve been so upset over the situation! Thank you!

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.

I'm so sorry for what you're dealing with. Why kind of relationship do you have with your current manager? Is there any way you could have the above conversation with her?

She must already have some understanding about the dilemma you're in. Let her know that you don't like leaving her hanging but you don't know when you'll have a handle on your health problem. She might offer to give you an indefinite leave of absence or she might reassure you that you could resign on good terms and stand a good chance of rehire. Or she might be completely unreasonable and then at least you'd know what you were dealing with.

I always think a face-to-face conversation is best for clarifying things; then you'll have an idea how to proceed from there. Wishing you improved health soon.

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Specializes in ER, Advocate, critical care, Case management.

Have they tried low dose Valium (2mg) or Ritalin?
I had an episode of Virgo that lasted 6wks and both of these are very successful at treating atypical vertigo.

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I don't understand why you don't qualify for FMLA, that seems like discrimination against a person with a disability.

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Specializes in NICU, PICU, Transport, L&D, Hospice.

A significant portion of migraine symptoms are often not associated with pain.   My spouse has atypical migraine, characterized by nystagmus, nausea/vomiting and debilitating vertigo which have increased in frequency and severity since treatment with cisplatin.  Avoiding triggers is the best treatment, in her view.  

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Specializes in ER, Advocate, critical care, Case management.
Quote

I don't understand why you don't qualify for FMLA, that seems like discriminationagainst a person with a disability.

To be eligible for FMLA you must work at a company full time for 1 year. As she started she had only been there 11 months. 

It is not her company being discriminatory it is a federal law there’s nothing they can do about it.

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Specializes in Pediatrics, Critical Care.

I also have vestibular migraines. I had a bad flare up when I first started my job as a tech about 3 years ago. I was only there about 4 months at the time and could barely walk a straight line and felt drunk all the time. Knew there was no way I could work full time. I just emailed my manager and had an open conversation with him. He was so nice about it. Immediately let me go part time and work as I needed to until I could qualify for FMLA. I'm still with the same hospital, different unit as I started a nursing job in October and my vestibular issues decided to flare up again (I had covid and I'm blaming that). Except this time I've also lost hearing in one ear.

I applied for my FMLA as it was due and I went from part to full time and it was denied because I didn't meet the minimum 1250 hours worked in the year. So I'm stuck in this bind of I have to call off but can't because I just started this job but so dizzy and discombobulated there is no possible way I can work. I did the same thing, very nervously reached out to my new manager and poured out my life story to her. She was 100% understanding. Told me to keep trying to apply and don't worry about call offs. Of course they aren't excessive and she is working with me too. I'd say that is your best bet. If your manager isn't approachable, start with an assistant who you have a good connection with. Unfortunately I'm in the same boat waiting on the FMLA at this point. Another option is to just have your doctor straight up write a work accommodation that you take to employee health. It doesn't have to be FMLA approved. I know you posted awhile ago, but hopefully this helps! 

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this only works if you have good management many of us do not 

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Specializes in Neuroscience.

Whoops, just realized the original post was from 2019...oh well, maybe my response will help someone ?

Hi! 

I am so sorry you're going thru this. I don't have a lot of advice on the keeping your job front, as you are in a tight spot with not having worked long enough to file for FMLA. But as far as migraine goes, I sadly have a wealth of experience,  so here goes.

1) the poster who mentioned low dose Valium was 100% correct. I went thru a similar journey with vertigo in my late teens, and still have a somewhat questionable dx of Menieres disease on my chart. I also do not have hearing loss, but I do have chronic migraine,  so vestibular migraine makes way more sense. However, that's neither here nor there. Point is, low dose Valium is a life saver. Works way better than meclizine. 

2) as far as screens being a trigger, get your eyes checked to be sure its not something else, but often its the blue light in the screen that triggers migraines. I have been wearing BluTech lenses since 2018, and they have made my poor light sensitive eyes way happier. I used to have eyes that hurt all the time, now its just when I have a migraine. And I believe that the glasses help me to use screens more without triggering a migraine. I wear them 100% of the time.

3) Aimovig has been a life altering preventative medication for me. It is a CGRP inhibitor, and has brought my migraines from chronic daily intractable down to 2x a week. I honestly probably wouldn't have made it thru nursing school if I hadn't gotten on it as soon as it was FDA approved. There are 3 other brands as well to consider. I had previously tried like 50 other preventative meds though, and the new ones can be hard to get approved if you haven't failed other meds. It's not my favorite, but Topamax is a first line tx to prevent migraine that is often tried. 

4) Try to get in to a neuro that specializes in Migraine &/or headache disorders. I like to say that migraine disease isn't "sexy" so a lot if neuros don't know jack about it. It is a complex neurological disorder that is mediated by many different factors, and it really does take an expert to navigate and treat successfully. 

5) Migraines are weird. If you are having vestibular migraines,  you may also be experiencing other types, and just have missed the signs, or mistook them for something else. For example, I get droopy face on the right side, slurred speech, confusion, transient aphasia, plus all the classic signs like unilateral head pain, stabbing eye pain, vision changes, nausea and vomiting, light sensitivity etc. Weird prodome symptoms like constant yawning, strange cravings, smelling burnt toast etc. 

I hope that some of this info helps, and I wish you all the best!! Do you have the option of STD thru work?  It doesn't necessarily protect your job, but a lot of employers will hold a job until an ee moves to LTD. I used to manage FMLA leaves for many companies,  and I saw this policy a lot. ❤

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