The disability associated with severe cases of migraine extends far beyond days spent in bed. Online, people talk about the ways that migraine has rendered them housebound. Driving, for instance, can be difficult; shifting lights trigger migraines and drug side effects cause clumsiness. People with migraine stay home because they fear perfumes or other foreign smells that can make them sick, or because they are simply too tired or hurting to venture outside.

– Joanna Kempner in Not Tonight.

Arriving at work a few weeks ago, I was mildly surprised at how easily the door at the bottom of the stairwell opened, but too absorbed in the book I was listening to to pay it much mind. But I was jolted into full awareness of my surroundings when I couldn’t get the door to my floor open. I took out my headphones and heard a wild whooshing and my heart sank.

One of my most reliable triggers for migraine attacks are rapid changes in barometric pressure. My building’s HVAC was undergoing some unannounced maintenance that day and the work had set up strong pressure gradients throughout the building.

I was optimistic. Maybe I wouldn’t get a migraine – I’d been doing so well lately and how big a pressure difference could the HVAC system realistically cause? Even if I did get a migraine, they often take hours to develop – maybe I’d make it to the meetings I had planned that day anyway.

But 45 minutes later my aura started and I headed home, angry and demoralized.

I often struggle to work 10 hours a week. Getting a migraine on a day that I was well from something I could have avoided is infuriating.

I often work and socialize from home. I simply don’t have the energy to navigate transit and stimulating environments every day. But I also have so much less control over my environment outside of my apartment and that carries very real risk for me.