The coverage of Michele Bachmann’s Migraines has engendered a great deal of conversation and many comments and questions. A couple of people made comments to me that I want to address.

One of these comments was made here on MyMigraineConnection:

"I suffer from debilitating migraine disease. I wish Ms. Bachman well, but I would not vote for her just based on the fact that she has migraine problem. I know how this disease effects your professional and personal life and makes you undependable to yourself and others."

Another was in an email I received:

"I've seen you write about how debilitating migraines can be and about how important it is to have more research funding because of the severity of this disease. If that's so, how could Representative Bachmann possibly serve as President?"

My response to both of these is that Migraine is not a one-size-fits-all disease. Its impact varies greatly, like spectrums, both in frequency and severity:

• On one end of the frequency spectrum, there are Migraineurs who have only the occasional Migraine. Some of these Migraineurs may have only a handful of Migraines during their entire lives. It progresses through chronic Migraine (Migraine on 15 or more days per month) on to people who have a Migraine every day.
  
• On one end of the severity and disability spectrum, there are Migraineurs whose Migraines are very mild. They may treat their Migraines with over-the-counter medications or may not treat them at all. Their Migraines aren't at all debilitating to them. This spectrum progresses through people whose Migraines are somewhat debilitating for a few hours on to people whose Migraines totally debilitate them and leave them in bed for days.
  

Leaving politics out of the discussion, to say that someone is unable to perform a job, any job, simply because they have Migraines shows how poorly the disease in understood, even by people who have it. To make that determination, we would need far more information, accurate and reliable information, than we have about Bachmann's Migraines. To determine if someone is unable to perform a job due to Migraines, we would need accurate information about:

• Migraine frequency;
• Migraine severity;
• the extent to which their Migraines incapacitate them; and
• the medications they take and whether those medications impact their ability to function, both physically and intellectually.

Yes, Migraine can be a very debilitating disease, but it isn't always debilitating. Some people function at very high levels with no loss of function during a Migraine attack. Others are so debilitated that they are totally disabled and draw Social Security disability benefits. To paint all Migraineurs with the same brush and say that anyone is unable to perform a job simply because they have Migraines demonstrates how poorly the disease is understood and the stigma that is attached to it.

There have been discussions about our needing a well known person to be a spokesperson for us to build awareness and understanding of Migraine. I suspect that comments and questions such as those I've received since the Bachmann story broke are perfect examples of why many celebrities don't want to talk about their Migraines. They value their careers, and they don't want the stigma of Migraine to negatively impact those careers.