Hi Annie,
  
 I know exactly what you are going through!  I am a work-aholic by nature myself and wouldn't dream of going on disability.  (I was on short-term disability for 3 months and I was going crazy!)  I am also putting on weight and dealing with other consequences as a result of my RSD.
  
 However, being on STD taught me a few things.  Stress definatly made my RSD worse.  I am now back at work at a nearly stress free job, though I am working more hours each day.  My RSD isn't nearly as bad as it was when I was in a more stressful position in a stressful environment.  I know you don't wish to change jobs, but I don't think working that many hours is doing you any favors.  If you still received a slightly negative review, then I wonder if working those extra hours are paying off...?
  
 I agree with Kara - I've heard good things about the software you can speak to and it will type for you.  What about getting an assistant?  I'm sure there are a few Grad students who would be willing to work with you, which would hopefully reduce some of your stress.
  
 Is there a disability resource center at the university?  I believe most schools have a center where students with both physical and learning disabilities can get help - maybe they could point you in the right direction?  Do you work with any other people with disabilities?  Are their needs being tended to?  Is there a secretary you could "share" with someone else who is also overworked?
  
 Good luck!
Best,
Meri