How to run a business with a long-term illness

Or: how to work, earn money, and stay (mostly) upright while your body regularly ignores your plans.

This isn’t a pity post. It’s not a “push through it” post either. It’s a realistic, lived-experience guide to building a sustainable business that actually works with your health – not against it.

I run my business alongside type 1 diabetes, chronic pain, chronic nerve pain, and the twice monthly migraine. The cherry on the chocolate cake is thanks to the diabetes, my immune system is weak af and thanks to the chronic pain, my diabetes isn’t sure how to react. Yes, pain influences blood sugars. So does medication, hormones, the weather…

Moving on. Before this, I worked in a corporate role – one I eventually had to leave because the commute, rigid hours, and lack of flexibility made it impossible to do my job properly while managing my health. I felt I was letting my team down and was advised by my GP at the time that I was making myself more ill.

That was the slap in the face I needed to make me realise my health should come first. It had only taken 5 operations.

This means some days I’m focused, energised and ticking things off like a dream… and other days I’m battling with my blood sugars, lying in a dark room, or wondering why my body has chosen today to be so dramatic because I carried a load of washing upstairs and did some gardening.

Here are the key things that make the biggest difference for me, that I hope will help others.

I OVERESTIMATE DEADLINES

If you live with a long-term illness, you already know this: you cannot guarantee how you’ll feel next Tuesday. Or this afternoon. Or in 20 minutes.

Early on in my business, I used to plan my work as if every day would be a good day. It wasn’t. Creeping deadlines, last-minute panic, flare-ups – all of it could’ve been avoided.

Now? I give padding everything:

• I build in buffer days
• I quote timelines that allow for bad health days
• I plan projects assuming I won’t feel amazing the whole time
• I work when I want and when I have the energy

And guess what? Work gets delivered, clients are happy… and my nervous system isn’t permanently fried like a KFC chicken leg.

Overestimating deadlines isn’t unprofessional – it’s self-preservation.

FLEXIBILITY IS KEY

Rigid schedules and chronic illness do not get along.

Some days my energy is best in the morning. Other days I’m useless until mid-afternoon. Sometimes a migraine means the day is simply… cancelled. Instead of fighting that reality, I’ve built my business around it.

That means:

• Flexible working hours
• Moving tasks around based on energy, not guilt
• Rescheduling without spiralling into self-blame

If your business only works when your body behaves perfectly, it’s not set up for real life.

MY WORK SETUP IS DESIGNED FOR COMFORT (NOT AESTHETIC POINTS)

I love a nice workspace as much as the next person. But comfort comes first – always.

Chronic pain means my setup has to support my body, not fight it. Migraines mean lighting, screens, and posture matter more than I’d like. And the diabetes means I need a stash of snacksies close by (which I feel is essential anyway, right?)

So I’ve stopped pretending I can work one way all the time.

• I have a comfortable main setup
• I work from different positions when needed
• I switch locations if my body needs a change
• I invest in things that genuinely help me do my job

Comfort isn’t indulgent. It’s the reason I can work at all some days.

I CHOOSE MY CLIENTS VERY CAREFULLY (NO RED FLAGS HERE)

The wrong clients will drain you faster than any illness flare-up.

I work best with people who:

• Respect boundaries and timelines
• Communicate clearly
• Trust me to do my job

I don’t overshare about my health, but I am clear about how I work. And the right clients don’t just accept that – they appreciate it. It also allows them to share and see that they are supported by someone who understands what they may be going through too.

Supportive working relationships make running a business with chronic illness infinitely more doable.

I HAVE A SUPPORT NETWORK THAT DOESN’T DRAIN ME

This one matters more than I realised at the beginning.

Running a business with a long-term illness is already demanding – doing it while surrounded by people who minimise, question, or drain you makes it ten times harder.

I’m intentional about the people around me: family, my husband, friends and my dogs. The ones who get it don’t need constant explanations. They don’t guilt me for resting. They don’t see flexibility as weakness.

Supportive people:

• Believe you when you say you’re not well
• Respect your boundaries without pushing
• Help steady you on the hard days instead of making them heavier

You don’t need a huge circle. You need the right one.

I’ve also learnt to listen to my own advice, and outsource. Lucky to find two wonderful associates who’ve helped calm my brain even more.

Being around people who don’t drain you is a form of energy management – and it’s just as important as any system or schedule.

I MEASURE SUCCESS BY SUSTAINABILITY, NOT STRICT GOALS

I am not interested in burning myself out to prove I’m capable. I have goals that can be moved or adapted.

Success, for me, looks like:

• A business with long term clients and income
• Systems that reduce mental load and that I enjoy using (this is important so I don’t throw my mouse at my screen)
• Enough energy left for an actual life
• Enjoyment, fun and being myself

Some weeks are quieter. Some days are slower. And that doesn’t mean I’m failing – it means I’m listening.

Success looks different for everyone.

A final thought

Running a business with a long-term illness is harder – yes. But it’s also possible, sustainable, and deeply worth doing your way.

If you’re adapting constantly, building buffers, and choosing care over chaos – you’re not behind. You’re being smart, and probably doing better than you think.

KLH